Manifestations Of Primary HIV Infection Research Articles

Multifocal encephalitis and recurrent shingles in HIV patient; A case presentation and review of literature

Neurological manifestations can occur in up to 17% of cases of HIV infection. 50–90% of individuals infected with HIV develop fever and non-specific symptoms within a few weeks of acquiring the infection. Viral encephalitis is an infectious process associated with a complicated diagnostic workup, limited treatment options, and significant morbidity and mortality. •F.A 51y old male patient, presented to Kasaralainy hospital, with Lt sided hemiparesis and an attack of Generalized seizure.•History of recurrent painful rash in thoracic region[Figure 1-1]. examination revealed multiple oral ulcers.•MRI Brain [Figure 1-2].•EEG: focal temporal and frontal epileptogenic activity•Patient was diagnosed as Encephalitis and started Acyclovir treatment and Antiepileptic drugs with no improvement• Laboratory investigations revealed HIV Ab --> positive•patient was started HAART Individuals with neurological manifestations of primary HIV infection should initiate HAART as these manifestations are associated with accelerated progression of HIV.

Primary HIV Infection: Expect the Unexpected

Typical manifestations of primary HIV infection (PHI) include a flu- or mononucleosis-like syndrome, including fever, pharyngitis, rash, or oral

Don't miss the primary HIV-infection

Primary HIV-infection (PHI) encompasses the first 6 months after HIV infection. Phylogenetic analysis demonstrates that PHI accounts for approximately half of onward transmissions. Between 25 and 90 % of patients with PHI present with an acute retroviral syndrome, but asymptomatic or atypical manifestations of PHI are substantially underestimated and occur in up to one third. Signs and symptoms include fever, fatigue, sore throat, exanthema, lymphadenopathy and diarrhea. The unspecific nature of these signs and symptoms preclude a reliable clinical diagnosis. Therefore, an HIV test should be performed routinely amongst persons at risk. The 4th generation Combo test detects PHI in most cases within two to three weeks after infection and should be used for screening. A routine use of the HIV-specific PCR for screening purposes is discouraged. During the last decade early antiretroviral therapy has been recognized as beneficial for patients with PHI and therefore is recommended.

Unusual primary HIV infection with colonic ulcer complicated by hemorrhagic shock: a case report

IntroductionTimely diagnosis of primary HIV infection is important to prevent further transmission of HIV. Primary HIV infection may take place without symptoms or may be associated with fever, pharyngitis or headache. Sometimes, the clinical presentation includes aseptic meningitis or cutaneous lesions. Intestinal ulceration due to opportunistic pathogens (cytomegalovirus, Epstein-Barr virus, Toxoplasma gondii) has been described in patients with AIDS. However, although invasion of intestinal lymphoid tissue is a prominent feature of human and simian lentivirus infections, colonic ulceration has not been reported in acute HIV infection.Case descriptionA 42-year-old Caucasian man was treated with amoxicillin-clavulanate for pharyngitis. He did not improve, and a rash developed. History taking revealed a negative HIV antibody test five months previously and unprotected sex with a male partner the month before admission. Repeated tests revealed primary HIV infection with an exceptionally high HIV-1 RNA plasma concentration (3.6 × 107 copies/mL) and a low CD4 count (101 cells/mm3, seven percent of total lymphocytes). While being investigated, the patient had a life-threatening hematochezia. After angiographic occlusion of a branch of the ileocaecal artery and initiation of antiretroviral therapy, the patient became rapidly asymptomatic and could be discharged. Colonoscopy revealed a bleeding colonic ulcer. We were unable to identify an etiology other than HIV for this ulcer.ConclusionThis case adds to the known protean manifestation of primary HIV infection. The lack of an alternative etiology, despite extensive investigations, suggests that this ulcer was directly caused by primary HIV infection. This conclusion is supported by the well-described extensive loss of intestinal mucosal CD4+ T cells associated with primary HIV infection, the extremely high HIV viral load observed in our patient, and the rapid improvement of the ulcer after initiation of highly active antiretroviral therapy. This case also adds to the debate on treatment for primary HIV infection, especially in the context of severe symptoms and an extremely high viral load.

Primary Human Immunodeficiency Virus Infection Presenting as Elevated Aminotransferases

Primary human immunodeficiency virus type 1 (HIV-1) infection is often under-diagnosed because of its nonspecific presentations. Elevated aminotransferase levels is one of its clinical manifestations, but is infrequently reported in the literature. The objective of this study was to investigate cases of elevated aminotransferases as a manifestation of primary HIV-1 infection. A retrospective chart review from October 1990 to May 2009 of HIV-1 infected patients in a registered database at a tertiary hospital was conducted to identify patients diagnosed with primary HIV-1 infection. An elevated aminotransferase level was broadly defined as above-normal values of alanine or aspartate aminotransferases. Acute hepatitis markers were determined using stored serum samples. Twenty-three of the 827 (2.8%) patients were identified as having a primary HIV-1 infection. All were male, with a median age of 26 years (range, 19-77 years), and the majority were men who had sex with men (19/23, 82.6%). The most common clinical manifestations were fever (95.7%), elevated aminotransferases (65.2%), fatigue (47.8%), and pharyngitis (47.8%). The median CD4 lymphocyte count was 374/μL (range, 109-674/μL) and the median log HIV viral load was 5.0 (range, 4.3-5.9). For the 15 patients with abnormal liver function tests, the median aspartate aminotransferase level was 112 U/L (range, 62-969 U/L) and the median alanine aminotransferase level was 146 U/L (range, 42-1,110 U/L). Elevated aminotransferases may be an initial manifestation of primary HIV infection and is more common than expected. Primary HIV-1 infection should be one of the differential diagnoses considered in young men presenting with unexplained, new-onset liver function impairment.

Primary HIV infection presenting as haemolytic crisis in a patient with previously undiagnosed glucose 6-phosphate dehydrogenase deficiency

Primary HIV infection presenting as haemolytic crisis in a patient with previously undiagnosed glucose 6-phosphate dehydrogenase deficiency

Multifocal central nervous system lesions and retropharyngeal lymphadenopathy on magnetic resonance imaging: an association that suggested progressive multifocal leukoencephalopathy in a patient with acute aphasia

Progressive multifocal leukoencephalopathy (PML) is an uncommon condition associated almost exclusively with impaired host immunity. More recently it has been recognized as a complication of the acquired immunodeficiency syndrome (AIDS), occurring in as many as 3.8% of these patients (Krupp et al, 1985). It may, rarely, be the initial manifestation of primary HIV infection, and in documented cases presents as focal limb weakness, altered mental state, ataxia, visual loss, headache and speech or language disturbance (Berger et al, 1987). We report a case of PML which presented as an acute aphasia, and in whom the diagnosis of an immunodeficient state was suggested by the magnetic resonance imaging (MRI) finding of enlarged retropharyngeal lymph nodes.