CLINICAL AND LABORATORY FEATURES ASSOCIATED WITH ACUTE HUMAN IMMUNODEFICIENCY VIRUS INFECTION

Important note: Information in this article was accurate in 1990. The state of the art may have changed since the publication date.

CLINICAL AND LABORATORY FEATURES ASSOCIATED WITH ACUTE HUMAN IMMUNODEFICIENCY VIRUS INFECTION

Infect Dis Ther; 3:71-82 1989. Unique Identifier : AIDSLINE ICDB/90665439
Crowe S; San Francisco General Hosp., San Francisco, CA

Abstract: HIV mononucleosis is an acute illness that may present as a syndrome resembling infectious mononucleosis or, less commonly, solely as an acute neurologic illness (ie, meningitis, encephalitis, polyneuropathy, or myelopathy). Epidemiology (prevalence and incidence, risk factors, and incubation period), clinical features of acute HIV, laboratory findings, and differential diagnosis of HIV mononucleosis are reviewed. The pathogenesis of HIV mononucleosis has not been established. It is probably related to HIV infection and replication within the reticuloendothelial system. This acute illness is part of the clinical spectrum of disease associated with HIV infection and should be considered in the differential diagnosis of infectious mononucleosis-like syndromes and acute neurologic disorders. The illness often is accompanied by an initial lymphopenia and thrombocytopenia, with the development of atypical lymphocytes and an inverted T-helper/T-suppressor (T4/T8) ratio later during the course. The data regarding the proportion of patients infected with HIV who develop HIV mononucleosis are conflicting, with no data on large studies available. The incubation period between infection and the onset of illness generally ranges from 6 days to 6 wk, with seroconversion usually occurring within 10 wk of commencement of symptoms. Although antibodies directed against HIV are not detected during the early phase of the illness, the development of HIV-antigen assays may permit earlier diagnosis. If available, viral cultures from lymphocytes, serum, or cerebrospinal fluid may aid early diagnosis. At present there is no indication that individuals who develop symptoms associated with acute infection have a long-term prognosis that differs from those who have asymptomatic infection. (44 Refs)

Keywords: Acquired Immunodeficiency Syndrome/*DIAGNOSIS AIDS Dementia Complex/*DIAGNOSIS AIDS Serodiagnosis Diagnosis, Differential Follow-Up Studies Human HIV/IMMUNOLOGY/*PATHOGENICITY HIV Infections/*DIAGNOSIS HIV Seropositivity/DIAGNOSIS Infectious Mononucleosis/*DIAGNOSIS Syndrome JOURNAL ARTICLE REVIEW REVIEW, TUTORIAL
901030
M90A0695

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