December 12, 2013
Worse Seroconversion Illness Linked to Faster AIDS Diagnosis
The severity of seroconversion illness in the six months following HIV acquisition is linked to a shorter time before the development of AIDS-related conditions, aidsmap reports. Publishing their findings in PLOS ONE, researchers from the international CASCADE collaboration studied a cohort of 1,108 HIV-positive individuals who had an identifiable, approximate seroconversion date.
The study defined severe seroconversion illness by the presence during primary HIV infection (PHI, the first six months after infection) of symptoms such as thrush in the mouth or throat, bronchitis, pneumonia or a low platelet count. Low CD4 measurements were additional markers.
There was available data on clinical symptom severity during PHI for 865 participants. Fifteen percent of them (127) had severe cases. Those with severe symptoms had a median AIDS-free survival period of 6.3 years, compared with 8.3 years for those who did not have severe symptoms.
A total of 443 participants had two CD4 counts available from PHI. Those who did not have a CD4 count below 350 had a median AIDS-free survival period of 8.1 years, compared with 5.4 years for those with one count below 350 and 3.9 years for those with two counts below 350. Those who had no CD4 measurements below 500 had a 7.5 year median AIDS-free survival period, compared with a respective 6.7 and 4.8 years for those with one or two tests below 500.
Those who had severe seroconversion illness symptoms and a CD4 count below 500 had twice the overall risk of AIDS-related illness or death when compared with those who only had severe symptoms.
The investigators concluded that those who are newly infected with HIV and who have at least one CD4 measurement below 350 or severe seroconversion illness symptoms would likely benefit from early antiretroviral treatment as well as close clinical monitoring. However, they stated that more research is needed to establish the benefit of early treatment during PHI.
To read the aidsmap story, click here.
To read the study abstract, click here.
Search: Seroconversion illness, primary HIV infection, PHI, CASCADE collaboration, PLOS One, AIDS-defining illnesses, HIV, CD4 count.
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