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Acute human immunodeficiency virus type 1 disease as a mononucleosis- like illness: is the diagnosis too restrictive?

  [ 35 votes ]   [ Discuss This Article ]
By Vanhems P, Allard R, Cooper DA, Perrin L, Vizzard J, Hirschel B, Kinloch-de Loes S, Carr A, Lambert J • www.ProHealth.com • May 20, 1997


The purpose of this study was to describe the frequency and
duration of clinical features at the time of acute human
immunodeficiency virus type 1 (HIV-1) disease in 218 patients
with documented symptomatic primary HIV-1 infection. The mean
duration of acute HIV-1 disease was 25.1 days (median, 20.0
days) and did not differ by gender, age, and risk factor. The
frequency and mean duration of clinical features occurring in
>50% of patients were as follows: fever, 77.1% and 16.9 days;
lethargy, 65.6% and 23.7 days; cutaneous rash, 56.4% and 15
days; myalgia, 54.6% and 17.7 days; and headache, 50.9% and
25.8 days. Only 15.6% of patients presented with a typical
mononucleosis-like illness (MLI) defined as fever, pharyngitis
or sore throat, and cervical adenopathy, and 10% had no
features of an MLI. A meningitis-like syndrome occurred in 20
patients (9.2%). Acute HIV-1 disease is more diverse than
previously reported, and the absence of fever or other MLI
features does not rule out acute HIV-1 disease.




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