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Severity and Prognosis of Acute Human Immunodeficiency Virus Type 1 Illness: A Dose-Response Relationship

Vanhems, Philippe ; Lambert, Jean ; Cooper, David A. ; Perrin, Luc ; Carr, Andrew ; Hirschel, Bernard ; Vizzard, Jeanette ; Loës, Sabine Kinloch-de ; Allard, Robert

In: Clinical Infectious Diseases, 1998, vol. 26, no. 2, p. 323-329

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    Titre
    • Severity and Prognosis of Acute Human Immunodeficiency Virus Type 1 Illness: A Dose-Response Relationship
    Auteur
    • Vanhems, Philippe. From the Research Centre, Hótel-Dieu de Montréal, and the Department of Social and Preventive Medicine, University of Montreal, Montreal, Quebec, Canada, Geneva, Switzerland
    • Lambert, Jean. From the Research Centre, Hótel-Dieu de Montréal, and the Department of Social and Preventive Medicine, University of Montreal, Montreal, Quebec, Canada, Geneva, Switzerland
    • Cooper, David A.. From the Research Centre, Hótel-Dieu de Montréal, and the Department of Social and Preventive Medicine, University of Montreal, Montreal, Quebec, Canada, Geneva, Switzerland
    • Perrin, Luc. From the Research Centre, Hótel-Dieu de Montréal, and the Department of Social and Preventive Medicine, University of Montreal, Montreal, Quebec, Canada, Geneva, Switzerland
    • Carr, Andrew. From the Research Centre, Hótel-Dieu de Montréal, and the Department of Social and Preventive Medicine, University of Montreal, Montreal, Quebec, Canada, Geneva, Switzerland
    • Hirschel, Bernard. From the Research Centre, Hótel-Dieu de Montréal, and the Department of Social and Preventive Medicine, University of Montreal, Montreal, Quebec, Canada, Geneva, Switzerland
    • Vizzard, Jeanette. From the Research Centre, Hótel-Dieu de Montréal, and the Department of Social and Preventive Medicine, University of Montreal, Montreal, Quebec, Canada, Geneva, Switzerland
    • Loës, Sabine Kinloch-de. From the Research Centre, Hótel-Dieu de Montréal, and the Department of Social and Preventive Medicine, University of Montreal, Montreal, Quebec, Canada, Geneva, Switzerland
    • Allard, Robert. From the Research Centre, Hótel-Dieu de Montréal, and the Department of Social and Preventive Medicine, University of Montreal, Montreal, Quebec, Canada, Geneva, Switzerland
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • Clinical Infectious Diseases, 1998, vol. 26, no. 2, p. 323-329. The University of Chicago Press
    Autre version électronique
    Classification
    • Santé
    Identifiant OAI-PMH
    • oai:doc.rero.ch:291980
    Summary
    This study examined the relationship between the severity of acute human immunodeficiency virus type 1 (HIV-1) illness and disease progression and death. The population included 218 patients with acute HIV-1 illness and 41 asymptomatic patients who underwent HIV-1 seroconversion; the patients were followed up prospectively. We analyzed progression to Centers for Disease Control and Prevention clinical categories B and C (AIDS-defining conditions) and death according to an additive clinical score (CS) based on six predictive clinical features at the time of acute HIV-1 infection. Compared with patients with a CS of 0 (asymptomatic patients), those with a CS of 3-4 and 5-6 had faster progression to category B disease (adjusted hazard ratio [HR], 1.39; 95% confidence interval [CI], 1.01-1.92; and HR, 1.80; 95% CI, 1.34-2.40; respectively); those with a CS of 5-6 had faster progression to category C disease (HR, 1.37; 95% CI, 1.01-1.89) and death (HR, 2.05; 95% CI, 1.27-3.32). Thus, the number of symptoms and signs at the time of acute HIV-1 illness affects disease progression and survival, even in symptomatic patients who have undergone seroconversion