Caution: Acute HIV infection may sometimes present as a serious and often fatal disease
Diagnosed with appendicitis and undergoing an exploratory operation had AIDS-related herpes throughout her digestive tract and spawned a colectomy! ...
A Swiss study of people who were diagnosed during the primary HIV infection syndrome found that a quarter of them had or developed a wide variety of early symptoms of primary HIV infectionTypical " Primary HIV infection; many of them serious and some who arrived endanger the lives of patients.
Gastrointestinal and neurological symptoms were particularly common in the early events of HIV infection syndrome. However, although these symptoms are often misinterpreted at first, they were, at least in this study, at least, significantly useful for early diagnosis of the the HIV infection.
The study on HIV infection
TheStudy on Primary Infection HIV Zurick is an observational study, from January 2002, we have seen documented symptoms and laboratory test results in any patient who is diagnosed with early syndrome of HIV infection. This is defined as follows:
Acute HIV infection.
- The presence of symptoms suggestive of infection by HIV, HIV negative or HIV positive antibody test with a p24 antigen and / or HIV positive RNA (viral load) indeterminate.
- In the absence of symptoms suggesting HIV infection, someone with a documented research HIV-antibody positive 90 in recent days, once a known date display.
Acute HIV infection:
- Symptoms suggestive of infection by HIV and HIV-positive antibody test, but with a negative test for HIV
- Without symptoms, someone with a documented test anti-HIV antibodies in recent 90-180 days since the date of known exposure to the virus.
The study was prospective part, that is, while most people have been diagnosed with HIV because they had symptoms, patients were followed for a period of six months and any event that this margin thought to be a case of Acute HIV infection, with the effective presence of HIV infection were observed, assisted and cataloged.
There is no broad consensus on how to define"Typical acute HIV disease"And therefore the researchers of this study had to use their own definitions, taken from a search on pre-existing medical literature.
They collected the seventeen symptoms and both laboratory abnormalities most commonly found in acute HIV infection and the most commonly reported symptom is fever, with one or more concurrent events in the 18 group of events and other conditions mentioned above or two or more of these conditionsin the absence of fever.
In addition to fever, the five main typical symptoms of acute HIV infection used for this study were elevated liver enzymes, malaise and fatigue, pharyngitis (sore throat), rash, and swollen lymph nodes. Weight loss with no apparent cause, headaches, muscle and joint pain and low platelet count were the "top five" in other studies.
The Disease Early infection by HIV atypical were then classified as:
- An opportunistic disease that defines AIDS. (Translator's note: tuberculosis for example, or recurrent vaginal candidiasis, in a typically female example).
- A symptom or group of symptoms not present in the list of "typical".
- Other signs, such as unusual laboratory abnormalities. (At some stage in my life my triglyceride count was above 3.300 and 200 is already considered excessively high)
If patients have any of these signs, they were classified as "atypical" even if these events were accompanied by other symptoms that belong to the list mentioned at the beginning of the text.
Results - asymptomatic patients
Of the patients 290, 202 (70%) had typical symptoms of HIV infection and patients 74 (25%) had atypical symptoms; only 14 individuals (5%), seven in the acute category and seven in recent category, no symptoms of primary HIV infection.
This is not surprising, since the most common reason for the study was to present people with symptoms suggestive.
It is important to keep this factor in mind because it [the factor] is smaller than usual to estimate the proportion of people who do not show any symptoms of infection, which, depending on a average between ten and sixty percentthe shape and definition of acute HIV disease that is carefully crafted and is seen.
This means thatand severe infectious atypical courses They appeared often in presentations of primary HIV infection documented in this study are less common than 30% prevalence found here; they may actually occur in anything between 2 15% and% of acute HIV infections.
People who were more likely to be asymptomatic were women, youth, and that they had been infected with HIV strains with resistance to various antiretroviral drugs (translator's note: It seems clear that people taking a medication, one way or another, have left "leak" relatively suppressed strains which when released from drug pressure evolved into more resistant strains of HIV. I ask everyone to make no mistake and if anyone tries to maintain a relationship, sex or shag and even quickie without a condom, throw holy water on it!). They also had a mean viral load in the first test, approximately 130.000 RNA copies per ml, whereas symptomatic patients (typical or not) had a mean viral load or 4 5 million copies / mL.
Results - atypical symptoms
Most people (83) with symptoms were acute category and of these, 69 (28,5) were classified as atypical. 17 of the recent category, 40 symptoms were classified as atypical.
People with atypical symptoms were more likely to have HIV subtype "non-B, straight and not be in any STDs monitoring (STDs). This is interesting because most acute HIV infection studies were performed in people with HIV subtype B, and because some subtypes, such as D, and LA, seem more virulent than subtype B.
People with atypical symptoms were more likely to be hospitalized because of these strains: 43% with atypical symptoms versus 11% with typical values.
There was a long list of atypical diseases linked to HIV infection. The most common causes were intestinal or neurological; more specifically linked to the central nervous system. However, the symptoms also involved ophthalmologic, pulmonary, renal, and other complications related to genitalia and skin problems.
There were constitutional symptoms such as severe weight loss and blood abnormalities such aspancytopenia(Translator's note: it is advisable to read the Wikipedia article that deals with this health problem because this is serious and, given the context of this article, it is not importing -sic- text here).
AIDS and AIDS-defining conditions were seen in 23% of people with atypical presentation. The disease AIDS-defining disease was accentuated by oral candidiasis or esophageal candidiasis, seen in 14% of atypical presentations. Most other AIDS-defining diseases consisted of intestinal or hepatic infections, usually cytomegalovirus (CMV) infections, a virus of the herpes virus family; there was also a single severe case of another strain of herpes virus in an inflammation initially diagnosed as Lyme disease, and a profound drop in platelet count, which was accompanied by a generalized HSV (herpes). Two of the cases of gastroesophageal reflux by candida, and also involved neurological symptoms.
A patient with severe diarrhea and wasting syndrome (weight loss without apparent cause) without generating other syndromes related to HIV.
The next most common symptom of the group of non-AIDS-defining diseases, such as gastrointestinal symptoms, was seen in 14% of atypical presentations. Half of these consisted of tonsillitis. Three gastrointestinal cases that led to surgeries: one involved a patient with severe gastrointestinal bleeding, an anal abscess and an inflammation of the gallbladder in a patient in whom an HIV viral loadof 100 million (!!!!!!!!!) copies / ml.
One patient had acute bacterial pneumonia, arthritis and acute renal failure: the other was originally diagnosed with appendicitis and underwent an exploratory operation; and had an AIDS-related herpes throughout her digestive tract which led to a colectomy (partial removal of the colon).
Central nervous system symptoms were observed in 12% of atypical presentations. These ranged from transient facial palsy in three patients, prolonged dizziness in a patient, and three patients who had acute psychiatric episodes (two of them were in the acute phase of the recent infection). Two patients had severe brain inflammation (encephalitis) and meningitis; one had to be treated in the Intensive Care Unit.
Other symptoms have been associated with cutaneous symptoms (9%), including dermatitis and cellulitis (soft tissue infection); lungs (6%, including three cases of pneumonia in addition to the above case); Blood abnormalities (6%, including three of pancytopenia) and urogenital symptoms (3%, including two other patients with renal insufficiency, apart from the above case).
Although some patients have become seriously ill, no one analyzed in the study died (death).
The average score of CD4 in all atypical presentations (including asymptomatic) was 421 cells / mm3. In most cases of atypical illness scores were recorded CD4 above 350 cells / mm3 and in a number of cases, including some of the most severe above 500 cells / mm3. Exactly 50% of patients had a viral load in the representation of more than 100.000 copies / ml.
Although 38 of patients with atypical symptoms were correctly diagnosed with acute HIV infection, and the rest has received a wide range of diagnostics before being tested for HIV (Translator's note: my primary syndrome was extremely violent and I wandered from hospital to hospital in the city of São Paulo always receiving the same diagnosis:. flu When I was attended to by a medical with capital letter I received the true diagnosis: Viral meningitis).
These include: 17% with other viral diseases, such as "kissing disease", infectious mononucleosis (Epstein-Barr virus); 6% to bacterial infections such as Streptococcus; 3% (ten patients) with syphilis; gastroenteritis of unknown cause, and only the diagnosis of a variety of diseases such as infective endocarditis, Lyme disease, appendicitis, diverticulitis and lymphoma. Twelve percent of patients were diagnosed by anti-HIV test registered with any other diagnosis.
However, in general, the erroneous diagnoses in this study do not appear to have delayed the diagnosis of seropositivity for HIV in these patients. The mean duration of HIV-positive diagnosis for HIV, after the first performance, was 29 days in people with typical symptoms and 32 days with atypical symptoms.
People who were being assisted in a clinic for STD were diagnosed out relatively "early" (21 days after the date of submission) than people who are watching hospital on an outpatient basis to other diseases (32 days) and others ( 33 days).
[Translator saddened Note: The highlighted section above contains two phonemes: A & E and GP are unintelligible to me and I put the paragraph in which they are contained in English below. If any soul to go through here know define the expressions I'll thank from the bottom of my heart. Here goes:
People Attending an STI clinic Were diagnosed Earlier (21 days after presentation) than people Attending hospital A & E (32 days) or GPs (33 days)].
The researchers note that there is only one individual symptom in the list of typical symptoms of HIV that is not presented as "very often" or "almost common" in patients who end up being diagnosed as HIV-negative to HIV.
It is the combination of symptoms that account together with the probability of recent exposure to HIV, and this study extends our knowledge of how this may present.
This study is a reminder that HIV can be present in a wide variety of different forms and can cause a great and severe acute disease, stressing the importance of testing after suspicion or exposure post-exposure prophylaxis (PEP) after a very recent.
Published: 27 May 2015
Translated from the original in English Acute HIV infection may present in many ways - sometimes as a serious illness by Cláudio Santos de Souza in 29 May 2015. (I do translation work for fair prices. Hire me and help me to pay the operating costs of this site)
Note the Soropositivo.Org Editor. The text forces me to rain on wet: If you think you may have had contact with HIV in less than 72 hours as to hospital and look for PEP and unfortunately this time window has ever been closed, seek urgently make the diagnosis for HIV as early as possible, given the fact that, in the wet raining again, ignoring a problem does not solve it and, on the contrary, in spite of not having had any of these in the study, you can not be so lucky so and, say, "go to death". (...)