Journal Information
Vol. 14. Issue 3.
Pages 291-293 (May - June 2010)
Share
Share
Download PDF
More article options
Vol. 14. Issue 3.
Pages 291-293 (May - June 2010)
Case report
Open Access
Acute HIV infection with rapid progression to AIDS
Visits
3719
Marcio de Oliveira Silva1,
Corresponding author
oliveiras_m@yahoo.com.br

Correspondence to: Rua Jorge Simões, 156 Ed. San Juan, apt. 302, Bonfim Salvador – Bahia – Brazil CEP: 40415-720.
, Milena Bastos1, Eduardo Martins Netto1, Nancy Alves de Lima Gouvea2, Alex Jose Leite Torres1, Esper Kallas2, David I. Watkins3, Marcus Altfeld4, Carlos Brites1
1 Universidade Federal da Bahia, Brazil
2 Faculdade de Medicina de São Paulo, Brazil
3 Wisconsin National Primate Research, USA
4 Partners AIDS Research Center, Infectious Diseases Unit, Massachusetts General Hospital, Boston, USA
This item has received

Under a Creative Commons license
Article information
Abstract

Acute HIV infection is rarely recognized as the signs and symptoms are normally unspecific and can persist for days or weeks. The normal HIV course is characterized by a progressive loss of CD4+ cells, which normally leads to severe immunodeficiency after a variable time interval. The mean time from initial infection to development of clinical AIDS is approximately 8-10 years, but it is variable among individuals and depends on a complex interaction between virus and host. Here we describe an extraordinary case of a man who developed Pneumocisits jiroveci pneumonia within one month after sexual exposure to HIV-1, and then presented with 3 consecutive CD4 counts bellow 200 cells/mm3 within 3 months, with no other opportunistic disease. Although antiretroviral therapy (AZT+3TC+ATZ/r) was started, with full adherence of the patient, and genotyping indicating no primary antiretroviral resistance mutations, he required more than six months to have a CD4 restoration to levels above 200 cells/mm3 and 10 months to HIV-RNA to become undetectable.

Keywords:
HIV
acute infection
progression
AIDS
Full text is only aviable in PDF
References
[1.]
J.O. Kahn, B.D. Walker.
Acute human immunodeficiency virus type 1 infection.
N Engl J Med, 339 (1989), pp. 33-39
[2.]
A. Munoz, M.C. Wang, S. Bass, et al.
Acquired immunodeficiency syndrome (AIDS)-free time after human immunodeficiency virus type 1(HIV-1) seroconversion in homosexual men.
Am J Epidemiol, 130 (1989), pp. 530-539
[3.]
G.W. Rutherford, A.R. Lifson, N.A. Hessol, et al.
Course of HIV-1 infection in a cohort of homosexual and bisexual men: an 11 year follow up study.
Br Med J, 301 (1990), pp. 1183-1188
[4.]
P. Baccheti, A.R. Moss.
Incubation period of AIDS in San Francisco.
Nature, 16 (1989), pp. 251-253
[5.]
M. Stevenson.
HIV-1 pathogenesis.
Nature Medicine, 9 (2003), pp. 853-860
[6.]
B. Rodriguez, A.K. Sethi, V.K. Cheruvu, et al.
Predictive value of plasma HIV RNA level on rate of CD4 T-cell decline in untreated HIV infection.
JAMA, 296 (2006 Sep 27), pp. 1498-1506
[7.]
J.W. Mellor, C.R. Rinaldo Jr., P. Gupto, et al.
Prognosis in HIV-1 infection predicted by the quantity of virus in plasma.
Science, 272 (1996), pp. 1167-1170
[8.]
R. Harrigan.
Predicting response to CCR5 Antagonists. Oral Session.
16th Conference on Retroviruses and Opportunistic Infections,
[9.]
A.R. Lifson, G.W. Rutherford, H.W. Jaffe.
The natural history of human immunodeficiency virus infection.
J Infect Dis, 158 (1998), pp. 1360-1367
[10.]
M. Magierowska, I. Theodorou, P. Debré, et al.
Combined genotypes of CCR5, CCR2. SDF1, and HLA genes on predict the long-term nonprogressor status in human immunodeficiency virus 1 infected individuals.
Blood, 93 (1999), pp. 936-941
[11.]
P.O. Flores-Villanueva, E.J. Yunis, J.C. Delgado, et al.
Control of HIV-1 viremia and protection from AIDS are associated with HLA BW4 homozygosity.
Proc Natl Acad Sci USA, 98 (2001), pp. 5140-5145
[12.]
Gange S. Data on natural history. Symposium on the Case of Rapidly Progressive Multi-drug Resistant HIV in New York City, February 10, 2005.
[13.]
J. Phair, L. Jacobson, R. Detils, et al.
acquired immunodefiency syndrome occurring within 5 years of infection with human immunodeficiency virus type-1: The Multicenter AIDS Cohort Study.
JAIDS, 5 (1992), pp. 490-496
[14.]
M. Markowitz, H. Mohri, S. Mehandru, et al.
Infection with multidrug resistant, dual-tropic HIV-1 and rapid progression to AIDS: a case report.
Lancet, 365 (2005), pp. 1031-1038
[15.]
S. Vento, G. Di Perri, T. Garofano, et al.
Pneumocystis carinii pneumonia during primary HIV-1 infection.
Lancet, 342 (1993), pp. 24-25
[16.]
M. Carrington, G.W. Nelson, M.P. Martin, et al.
HLA and HIV-1: heterozygote advantage and B*35-CW*04 disadvantage.
Science, 283 (1999), pp. 1748-1752
[17.]
S. Itescu, U. Marthur-Wagh, M.L. Skovron, et al.
HLA- B35 is associated with accelerated progression to AIDS.
J Acquir Immune Defic Syndr, 5 (1992), pp. 37-45
[18.]
T. Sahmoud, Y. Laurian, C. Gazengel, Y. Sultan, C. Gautreau, D. Costagliola.
Progression to AIDS in French haemophiliacs: association with HLA-B35.
AIDS, 7 (1993), pp. 497-500
[19.]
X. Gao, G.W. Nelson, P. Karacki, et al.
Effect of a single amino acid change in MHC class I molecules on the rate of progression to AIDS.
N Engl J Med, 344 (2001), pp. 1688-1775
[20.]
B.S. Taylor, M.E. Sobieszczyk, F.E. McCutchan, et al.
The challenge of HIV-1 subtype diversity.
N Engl J Med, 10 (2008), pp. 1590-1602
Copyright © 2010. Elsevier Editora Ltda.. All rights reserved
Download PDF
The Brazilian Journal of Infectious Diseases
Article options
Tools