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HIV Transmission and Education >> Am I Infected?

Anonymous
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Percent of HIV symptoms
      12/18/06 07:08 AM

Signs and symptoms

After an incubation period of a few days to a few weeks after exposure to HIV, most infected individuals present with an acute flu-like illness. Acute HIV-1 infection is a very heterogeneous syndrome and individuals presenting with more severe symptoms during acute infection and a longer duration of the acute infection syndrome tend to progress more rapidly to AIDS (Vanhems 1998, Vanhems 2000, Sinicco 1993, Pedersen 1989, Keet 1993, Lindback 1994). The clinical symptoms of acute HIV-1 infection were first described in 1985 as an illness resembling infectious mononucleosis (Cooper 1985). The most common symptoms (see Table 1) are fever, maculopapular rash, oral ulcers, lymphadenopathy, arthralgia, pharyngitis, malaise, weight loss, aseptic meningitis and myalgia (Kahn 1998). In one study (Hecht 2002), fever (80 %) and malaise (68 %) had the highest sensitivity for clinical diagnosis of acute HIV-1 infection, whereas loss of weight (86 %) and oral ulcers (85 %) had the highest specificity. In this study, the symptoms of fever and rash (especially in combination), followed by oral ulcers and pharyngitis had the highest positive predictive value for diagnosis of acute HIV-1 infection. In another study (Daar 2001), fever, rash, myalgia, arthralgia and night sweats were the best predictors for acute HIV-1 infection.

Table 1: Main symptoms of acute HIV-1 infection

Symptom


Frequency


Odds ratio (95% CI)

Fever


80%


5.2 (2.3-11.7)

Rash


51%


4.8 (2.4-9.8)

Oral ulcers


37%


3.1 (1.5-6.6)

Arthralgia


54%


2.6 (1.3-5.1)

Pharyngitis


44%


2.6 (1.3-5.1)

Loss of appetite


54%


2.5 (1.2-4.8)

Weight loss > 2.5 kg


32%


2.8 (1.3-6.0)

Malaise


68%


2.2 (1.1-4.5)

Myalgia


49%


2.1 (1.1-4.2)

Fever and rash


46%


8.3 (3.6-19.3)

From: Hecht FM et al. Use of laboratory tests and clinical symptoms for identification of primary HIV infection. AIDS 2002, 16: 1119-1129

The symptomatic phase of acute HIV-1 infection lasts between 7 - 10 days, and rarely longer than 14 days. The nonspecific nature of the symptoms poses a great challenge to the clinician and underlines the importance of a detailed history of exposure.


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