Important note: Information in this article was accurate in 1997. The state of the art may have changed since the publication date.

Reuters NewMedia, Inc.; Tuesday December 16, 6:29 pm EST
Michael Conlon

The finding could help better single out people in the very early or "acute" stage of infection with the human immunodeficiency virus -- HIV -- when their blood has not yet produced telltale antibodies to the virus but when they are nonetheless infectious, the report said.

The U.S. National Institute of Allergy and Infectious Diseases, which helped fund the study, said the results should help physicians combat the spread of AIDS in developing nations where diagnoses are often difficult.

It said a recent report estimated that 16,000 people are being infected with the virus every day, most of them in sub-Saharan Africa and Asia.

The study, published in this week's Journal of the American Medical Association, was based on a look at patients seeking treatment at clinics in Pune, India. The same research team reported separately in the publication that AIDs is being spread in India to young married women by husbands who visit prostitutes.

Robert Bollinger, associate professor of medicine at Baltimore's Johns Hopkins University Medical School, an author of the report, said blood tests that were negative for HIV antibodies were retested when patients reported one or more of the three symptoms.

The second look at the blood tests often found a HIV virus protein called p24 antigen which can confirm the presence of the infection and which has been used for some time as a diagnostic clue, the study said.

"We were able to show that certain symptoms tended to appear in people who had p24 even before they had a positive antibody test," said Bollinger.

"Those with a recent history of joint pain were more than six times more likely to test positive for p24 antigen," he said, "and those with a recent history of night sweats had a ninefold increase in the risk of testing positive.

"Also, patients who did not test positive for antibodies but did report fever within the last three months were five times more likely to test positive for p24 antigen than those without a recent history of fever," he added.

The study's results conflict with previous findings that up to 90 percent of people in the early stage of HIV infection have influenza-like symptoms.

"We found in fact that only about half of those with acute HIV had symptoms that would distinguish them," Bollinger said in an interview.

"Out of all the symptoms we only found three that were really able to distinguish those with acute cases -- fever, joint pains and night sweats," he added.

Thomas Quinn of Johns Hopkins University, another of the report's authors, said "Our data suggest that many of the previously described signs and symptoms of acute HIV infection may be relatively nonspecific, particularly in developing country settings where other endemic diseases with similar symptoms are more common."

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