Journal Article

Severity and Prognosis of Acute Human Immunodeficiency Virus Type 1 Illness: A Dose-Response Relationship

Philippe Vanhems, Jean Lambert, David A. Cooper, Luc Perrin, Andrew Carr, Bernard Hirschel, Jeanette Vizzard, Sabine Kinloch-de Loës and Robert Allard

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 26, issue 2, pages 323-329
Published in print February 1998 | ISSN: 1058-4838
Published online February 1998 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/516289
Severity and Prognosis of Acute Human Immunodeficiency Virus Type 1 Illness: A Dose-Response Relationship

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This study examined the relationship between the severity of acute human immunodeficiency virus type 1 (HIV-1) illness and disease progression and death. The population included 218 patients with acute HIV-1 illness and 41 asymptomatic patients who underwent HIV-1 seroconversion; the patients were followed up prospectively. We analyzed progression to Centers for Disease Control and Prevention clinical categories B and C (AIDS-defining conditions) and death according to an additive clinical score (CS) based on six predictive clinical features at the time of acute HIV-1 infection. Compared with patients with a CS of 0 (asymptomatic patients), those with a CS of 3–4 and 5–6 had faster progression to category B disease (adjusted hazard ratio [HR], 1.39; 95% confidence interval [CI], 1.01–1.92; and HR, 1.80; 95% CI, 1.34–2.40; respectively); those with a CS of 5-6 had faster progression to category C disease (HR, 1.37; 95% CI, 1.01–1.89) and death (HR, 2.05; 95% CI, 1.27–3.32). Thus, the number of symptoms and signs at the time of acute HIV-1 illness affects disease progression and survival, even in symptomatic patients who have undergone seroconversion.

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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