Presentation
Lessons from practice HIV should be considered in all patients presenting with a new rash. Acute HIV infection can present as febrile illness associated with any rash, including erythema multiforme. [mja.com.au]
Heightened awareness of the cutaneous presentation of parvovirus B19 infection can help avoid unnecessary hospitalization and patient anxiety. [mdedge.com]
Meeting summary The meeting included: introductory remarks (presented by Meg Doherty); an overview plenary session on acute HIV infection (AHI) (presented by Myron Cohen); scoping review findings (presented by Sarah Rutstein and Joseph Tucker); a panel [who.int]
Case presentation A 27 year old female, presented to our hospital on 5 th July 2013 with fever, throat pain, non productive cough, anorexia and weight loss (4 kg) for one month duration. [bmcinfectdis.biomedcentral.com]
Analysis included MSM self-presenting to a community screening program in San Diego and 1) tested positive for AHI (antibody-negative, HIV NAT-positive) from 2007–2017 or 2) tested HIV NAT-negative in 2017. [insights.ovid.com]
Entire Body System
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Fever
Our patient’s fever, rash, and absolute lymphopenia focused attention on possible HIV infection, which caused the patient significant anxiety while awaiting the results of HIV testing. [mdedge.com]
Myalgia (OR 6.6 [95% CI: 2.5 to 17.5]), fever (OR 9.5 [95% CI: 3.5 to 25.7]), weight loss (OR 7.4 [95% CI: 1.9 to 29.5]), and CRAI plus 2 male partners (OR 7.4 [95% CI: 3.1 to 17.6]) remained significant in the multivariate model. [insights.ovid.com]
They include: Fever Fatigue Sore throat Weight loss Muscle aches Headache Nausea Night sweats Diarrhea Rash Having these symptoms does not mean that you have HIV, because these same symptoms can occur with the flu, mono, or strep throat. [depts.washington.edu]
The syndrome is characterized by fever, sore throat, headache, skin rash and swollen glands (lymphadenopathy). This syndrome precedes seroconversion -- the development of detectable antibodies to HIV in the blood as a result of the infection. [medicinenet.com]
HIV-seronegative adults presenting at the Manhiça District Hospital, Mozambique, with reported-fever were tested for VL. [nature.com]
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Lymphadenopathy
The syndrome is characterized by fever, sore throat, headache, skin rash and swollen glands (lymphadenopathy). This syndrome precedes seroconversion -- the development of detectable antibodies to HIV in the blood as a result of the infection. [medicinenet.com]
Inguinal lymphadenopathy was noted on examination. A skin examination revealed an extensive macular papular rash affecting his face, trunk and limbs, with an erosion noted on his soft palate. [mja.com.au]
Eleven symptoms (headache, pharyngitis, rash, myalgia, fatigue, fever, night sweats, gastrointestinal symptoms, arthralgia, weight loss 2.5 kg, or lymphadenopathy) in the 14 days prior to testing were assessed; risk behaviours for the 3 months prior to [insights.ovid.com]
[…] associated with Epstein-Barr virus, cytomegalovirus, human herpesvirus types 6 and 7, hepatitis B virus, rubella virus, and varicella zoster virus. 4 Parvovirus B19 infection is commonly associated with systemic manifestations such as fever, fatigue, and lymphadenopathy [mdedge.com]
Nucleic acid structure and expression of the human AIDS/lymphadenopathy retrovirus. Nature. 1985 Feb 7-13. 313(6002):450-8. [Medline]. Gallo R, Wong-Staal F, Montagnier L, Haseltine WA, Yoshida M. HIV/HTLV gene nomenclature. [medscape.com]
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Apyrexia
Patient’s condition progressively improved, apyrexia was documented and she was discharged, with a progressively reducing doses of steroids, by 20 th of September (after 11 weeks of hospital stay; 9 weeks of FTC/TDF ETV DRV/r). [bmcinfectdis.biomedcentral.com]
Musculoskeletal
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Osteoporosis
These include: Chronic renal failure Diabetes Osteoporosis Liver damage Heart disease Hyperlipidemia, an excess of fats in the blood Lipodystrophy, metabolic changes in how the body uses and stores fat Depression People who have contracted HIV become [ada.com]
Skin
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Maculopapular Rash
Acute HIV infection generally occurs within 4–10 weeks from the time of HIV exposure, with 95% of patients seroconverting within 6 months. 2 - 4 Acute HIV infection is associated with a maculopapular rash in up to 80% of cases, which presents 48–72 hours [mja.com.au]
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Petechiae
Examination revealed bright red confluent erythema of both legs extending to the lower abdomen, with petechiae on the palms ( Figure 2 ), soles, toes, and fingers. Several small scrotal ulcers with well-defined borders were noted. [mdedge.com]
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Papular Rash
A skin examination revealed an extensive macular papular rash affecting his face, trunk and limbs, with an erosion noted on his soft palate. [mja.com.au]
Neurologic
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Motor Symptoms
However, there are some instances in acute or primary infection when treatment is strongly recommended, including: Neurological symptoms (meningitis, cognitive or motor symptoms, weakness/numbness as a result of nerve damage) Any AIDS-defining illness [aidsmap.com]
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Rabies
False-positive human immunodeficiency virus screening test related to rabies vaccination. Arch Pathol Lab Med. 1994 Aug. 118(8):805-6. [Medline]. Mac Kenzie WR, Davis JP, Peterson DE, Hibbard AJ, Becker G, Zarvan BS. [medscape.com]
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Cognitive Deficit
More specifically, 33% had cognitive deficits, 34% had motor control difficulties, and 20% had neuropathy, the investigators found. Many had more than one symptom. One participant had Guillain-Barré syndrome, the only severe condition in the group. [psychiatryadvisor.com]
Workup
Treatment with intravenous fluids and intramuscular penicillin G was started empirically, pending a workup for infectious disease. [mdedge.com]
Microbiology
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Treponema Pallidum
Treponema pallidum particle agglutination assay, cryptococcal antigen, CMV antigen and CMV viral load in blood also negative. Chest X-Ray, abdominal ultrasound, chest and abdominal CT scan did not reveal relevant abnormality. [bmcinfectdis.biomedcentral.com]
Biopsy
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Liver Biopsy
Fig. 3 Bone Marrow Biopsy: activated macrophages engulfing erythrocytes suggesting HS Liver biopsy (25 th July) revealed: portal inflammatory infiltrates, disperse necroinflammatory lesions, moderate cholestasis, hepatocyte ballooning and multifocal esteatosis [bmcinfectdis.biomedcentral.com]
Vibration-controlled transient elastography (VCTE) measures shear wave velocity (expressed in kilopascals) and assesses a larger volume of liver parenchyma than liver biopsy. [hivguidelines.org]
Treatment
Nonetheless, you could still pass on HIV if you are not taking treatment. [aidsmap.com]
It’s important to discuss all treatment options and potential side effects with your healthcare provider to determine the right time to start and continue HIV treatment. [healthline.com]
With Efavirenz, Tenofovir, and Emtricitabine Followed by Two Days Off Treatment Versus Continuous Treatment Efavirenz (DB00625) Emtricitabine (DB00879) Tenofovir (DB14126) NCT00224458 Combination of Efavirenz and Truvada - COMET Study Efavirenz (DB00625 [drugbank.ca]
These participants were treated for two to five years and maintained undetectable viral load before treatment was interrupted. [hivresearch.org]
Prognosis
Expectations (prognosis) There is no cure for HIV infection or AIDS. However, appropriate treatment can dramatically improve the length and quality of life for persons infected with HIV, and can delay the onset of AIDS. [ufhealth.org]
[…] such as semen, containing HIV come into contact with mucosal surfaces HIV binds to and infects local CD4 positive cells, predominantly macrophages. intravenous administration during blood transfusion delivers a high dose of virus resulting in a poor prognosis [gpnotebook.co.uk]
Prognosis in HIV-1 infection predicted by the quantity of virus in plasma. Science 1996; 272(5265):1167-70. [ Links ] 8. Harrigan R. Predicting response to CCR5 Antagonists. [scielo.br]
Reactive haemophagocytic syndrome in 58 HIV-1 infected patients: clinical features, underlying diseases and prognosis. AIDS. 2010;24:1299–306. 8. Adachi E, Koibuchi T, Imai K, et al. [bmcinfectdis.biomedcentral.com]
Potential Implications for Public Health The ability to identify patients with acute HIV infection in real time could potentially provide clinical benefits to the individuals identified since early initiation of antiretroviral therapy may improve long-term prognosis [jamanetwork.com]
Etiology
Current concepts in the etiology and treatment of Behçet disease. Surv Ophthalmol 2005 ; 50: 297 – 350. Google Scholar Crossref Medline ISI 8. Patel, N, Patel, N, Espinoza, LR. [journals.sagepub.com]
Etiological aspects of reactive hemophagocytoses: retrospective study in 99 patients. Rev Med Interne. 1997;18:855–64. 7. Fardet L, Lambotte O, Meynard JL, et al. [bmcinfectdis.biomedcentral.com]
Additional studies are needed to define the exact timing, duration, and etiology of this observation. [jem.rupress.org]
"Diarrhea in developed and developing countries: magnitude, special settings, and etiologies". Reviews of Infectious Diseases. 12 (Suppl 1): S41–50. doi : 10.1093/clinids/12.Supplement_1.S41. PMID 2406855. Gazzard, B; Balkin, A; Hill, A (2010). [en.wikipedia.org]
They are useful for patients with highly discordant results on noninvasive testing and in patients suspected of having a second etiology for liver disease in addition to HCV infection. [hivguidelines.org]
Epidemiology
The Women's Interagency HIV Study, Epidemiology, 1998, vol. 9 2 (pg. 117 - 125 ) 37. [academic.oup.com]
Google Scholar 17. 2000 HIV Prevention and Community Planning Epidemiologic Profile for North Carolina. Raleigh: North Carolina Department of Health and Human Services; 2000. 18. Ly T, Edlinger C, Vabret A. et al. [jamanetwork.com]
This quantity changes with epidemic stage, epidemiological context, and the stage of the HIV treatment scale-up. [pnas.org]
E Losina Division of General Medicine, Massachusetts General Hospital, Boston, MA, USA The Harvard Center for AIDS Research (CFAR), Boston, MA, USA Departments of Biostatistics and Epidemiology, Boston University School of Public Health, Boston, MA, USA [onlinelibrary.wiley.com]
Clinical and epidemiologic features of primary HIV infection. Ann Intern Med. 1996;125(4):257-264. Daar E.S. Virology and immunology of acute HIV type 1 infection. AIDS Res Hum Retroviruses. 1998;14(Suppl 3):S229-234. [thebodypro.com]
Prevention
At this level, it is no longer transmissible, according to the Center for Disease Control and Prevention (CDC). [medicalnewstoday.com]
Starting treatment soon after diagnosis prevents infecting others and protects the immune system. [aidsmap.com]
A Publication From the Association of Public Health Laboratories and the Centers for Disease Control and Prevention. April 2009. Available at . Accessed: December 1, 2011. Center for Disease Controls and Prevention. [medscape.com]
A variety of prevention methods are available including condoms (male or female), pre-exposure prophylaxis (PrEP), treatment as prevention, and post-exposure prophylaxis (PEP). Avoid sharing needles. [healthline.com]
Pre-exposure prophylaxis (PrEP) for HIV prevention: promoting safe and effective use in the United States. Atlanta: Centers for Disease Control and Prevention; . [ Google Scholar ] 90. Garcia-Lerma JG, Cong ME, Mitchell J, et al. [ncbi.nlm.nih.gov]