Incubation Time of Acute Human Immunodeficiency Virus (HIV) Infection and Duration of Acute HIV Infection Are Independent Prognostic Factors of Progression to AIDS

Abstract In a national online survey, we assessed awareness and knowledge of acute human immunodeficiency virus (HIV) infection manifestation among 1748 men who have sex with men (MSM). Only 39% of respondents were aware that acute HIV infection may be accompanied by symptoms. Education and increased access to acute HIV testing may facilitate MSM to appropriately seek acute HIV testing.

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Case 36

Oxford Case Histories in Infectious Diseases and Microbiology ◽

10.1093/med/9780198846482.003.0036 ◽

2020 ◽

pp. 247-254

Author(s):

Andrew Woodhouse

Keyword(s):

Human Immunodeficiency Virus ◽

Hiv Infection ◽

Immune Function ◽

Treatment Strategies ◽

Current Treatment ◽

Newly Diagnosed ◽

Acute Hiv Infection ◽

Immunodeficiency Virus ◽

Acute Hiv

Human immunodeficiency virus (HIV) infection is a worldwide infection and new cases continue to occur. Recognizing features of acute HIV infection and also underlying conditions that might reflect longer-standing infection are key to diagnosis. This allows treatment to be started which can maintain or improve health and prevent further deterioration of immune function. Treatment is indicated for the majority of newly diagnosed cases irrespective of immune function status. Current treatment strategies are so effective and tolerable now compared to early antiretroviral regimens that HIV has become a long-term manageable condition for the majority of newly diagnosed people who are able to access antiretroviral therapy.

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Colorectal Disorders in Acute Human Immunodeficiency Virus Infection: A Case Series

Open Forum Infectious Diseases ◽

10.1093/ofid/ofw014 ◽

2016 ◽

Vol 3 (1) ◽

Cited By ~ 1

Author(s):

Theppharit Panichsillapakit ◽

Derek Patel ◽

Joanne Santangelo ◽

Douglas D. Richman ◽

Susan J. Little ◽

...

Keyword(s):

Human Immunodeficiency Virus ◽

Hiv Infection ◽

Acute Infection ◽

Case Series ◽

Low Grade ◽

Gi Tract ◽

Acute Hiv Infection ◽

First Case ◽

Immunodeficiency Virus ◽

Acute Hiv

Abstract Background. The gastrointestinal (GI) tract is important in the pathogenesis of human immunodeficiency virus (HIV) infection. We report a case series of lower GI endoscopic and histopathologic findings of HIV-infected individuals after presentation with acute infection. Methods. We performed a retrospective case review of individuals infected with HIV who enrolled between August 2010 and April 2013 in a primary infection treatment trial. All participants started the trial during acute infection and underwent colonoscopy with biopsies at baseline and after the start of antiretroviral treatment. Results. Twenty acutely infected individuals were included in the study (mean age, 33 years; range, 20–54 years). All participants were male who reported having receptive anal sex as an HIV risk factor. Nine individuals (45%) had at least 1 finding by colorectal pathology; 1 person had 2 diagnoses (diverticulosis and focal active proctitis). The histopathological findings revealed anal dysplasia in 3 cases: 2 had high-grade anal intraepithelial neoplasia (AIN) and 1 had low-grade AIN. Two persons had a colorectal polyp, 1 hyperplastic and 1 adenomatous. Three persons were diagnosed with diverticulosis, and 2 persons were diagnosed with proctitis, including 1 with focal active proctitis and 1 with cytomegalovirus proctitis. Conclusions. To our knowledge, this is the first case series report of lower GI disorders in acute HIV-infected individuals. Although the causal relationship remains uncertain, we describe the endoscopic findings that were observed during acute HIV infection among men who have sex with men. Understanding the prevalence of these pathologies may likely shed light on how acute HIV infection damages the lower GI tract.

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Acute Human Immunodeficiency Virus (HIV) Syndrome After Nonadherence to Antiretroviral Therapy in a Patient With Chronic HIV Infection: A Case Report

Open Forum Infectious Diseases ◽

10.1093/ofid/ofu112 ◽

2014 ◽

Vol 1 (3) ◽

Cited By ~ 1

Author(s):

Seong K. Choi ◽

Christopher J. Graber

Keyword(s):

Human Immunodeficiency Virus ◽

Antiretroviral Therapy ◽

Hiv Infection ◽

Rare Case ◽

Acute Illness ◽

Hiv Rna ◽

Acute Retroviral Syndrome ◽

Immunodeficiency Virus ◽

Acute Hiv ◽

Chronic Hiv Infection

Abstract We report a rare case of acute human immunodeficiency virus (HIV) syndrome in a patient with chronic HIV infection with acute illness indistinguishable from acute retroviral syndrome. The patient presented with an acute febrile mononucleosis-like illness after increasing nonadherence to antiretroviral therapy. A marked increase in HIV RNA level of 1 220 000 copies/mL from less than 20 copies/mL occurred within 3 weeks. The diagnosis of acute HIV syndrome was made after alternative causes of illness were ruled out.

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Timeliness of Human Immunodeficiency Virus Diagnosis and Antiretroviral Treatment Initiation in the Era of Universal Testing and Treatment

The Journal of Infectious Diseases ◽

10.1093/infdis/jiz148 ◽

2019 ◽

Vol 220 (4) ◽

pp. 648-656 ◽

Cited By ~ 3

Author(s):

McKaylee M Robertson ◽

Sarah L Braunstein ◽

Donald R Hoover ◽

Sheng Li ◽

Denis Nash

Keyword(s):

Human Immunodeficiency Virus ◽

Hiv Infection ◽

Antiretroviral Treatment ◽

Proportional Hazards ◽

Treatment Initiation ◽

Hiv Diagnosis ◽

Acute Hiv Infection ◽

Art Initiation ◽

Universal Testing ◽

Immunodeficiency Virus

Abstract Background We describe the timing of human immunodeficiency virus (HIV) diagnosis and antiretroviral treatment (ART) initiation after implementation of universal testing and treatment policies in New York City (NYC). Methods Using NYC population-based HIV registry data for persons with HIV diagnosed from 2012 through 2015 and followed up through June 2017, we examined trends in the proportion with diagnosis soon after HIV infection (ie, with CD4 cell count ≥500/μL or with acute HIV infection) and used Kaplan-Meier plots and proportional hazards regression to examine the timing of ART initiation after diagnosis. Results Among 9987 NYC residents with HIV diagnosed from 2012 to 2015, diagnosis was early in 35%, and 87% started ART by June 2017. The annual proportion of persons with early diagnosis did not increase appreciably (35% in 2012 vs 37% in 2015; P = .08). By 6 months after diagnosis, 62%, 67%, 72% and 77% of persons with HIV diagnosed in 2012, 2013, 2014, or 2015, respectively, had started ART, with median (interquartile range) times to ART initiation of 3.34 (1.34–12.75), 2.62 (1.28–10.13), 2.16 (1.15–7.11), and 2.03 (1.11–5.61) months, respectively. Conclusions Although recommendations for ART initiation on diagnosis are increasingly being implemented, the findings of the current study suggest that immediate treatment initiation is not universal. Continued efforts are needed to expand and better target HIV testing to promote earlier diagnosis.

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Cathepsin G, a Neutrophil-Derived Serine Protease, Increases Susceptibility of Macrophages to Acute Human Immunodeficiency Virus Type 1 Infection

Journal of Virology ◽

10.1128/jvi.74.15.6849-6855.2000 ◽

2000 ◽

Vol 74 (15) ◽

pp. 6849-6855 ◽

Cited By ~ 33

Author(s):

Hiroyuki Moriuchi ◽

Masako Moriuchi ◽

Anthony S. Fauci

Keyword(s):

Human Immunodeficiency Virus ◽

T Cells ◽

Hiv Infection ◽

Serine Protease ◽

Human Immunodeficiency Virus Type ◽

Cathepsin G ◽

Immunodeficiency Virus ◽

Acute Hiv ◽

Hiv 1

ABSTRACT Neutrophils dominate acute inflammatory responses that generally evolve into chronic inflammatory reactions mediated by monocyte/macrophages and lymphocytes. The latter cell types also serve as major targets for human immunodeficiency virus type 1 (HIV-1). In this study we have investigated the role of neutrophil products, particularly cathepsin G, in HIV infection. Cathepsin G induced chemotaxis and production of proinflammatory cytokines by macrophages but not CD4+ T cells. Pretreatment with cathepsin G markedly increased susceptibility of macrophages but not CD4+ T cells to acute HIV-1 infection. When macrophages were exposed to pertussis toxin prior to cathepsin G treatment, the cathepsin G-mediated effect was almost abrogated, suggesting that enhancement of HIV-1 replication by cathepsin G requires Gi protein-mediated signal transduction. Although prolonged exposure to cathepsin G suppressed HIV infection of macrophages, serine protease inhibitors, which are exuded from the bloodstream later during inflammatory processes, neutralized the inhibitory effect. Neutrophil extracts or supernatants from neutrophil cultures, which contain cathepsin G, had effects similar to purified cathepsin G. Thus, cathepsin G, and possibly other neutrophil-derived serine proteases, may have multiple activities in HIV-1 infection of macrophages, including chemoattraction of monocyte/macrophages (HIV-1 targets) to inflamed tissue, activation of target cells, and increase in their susceptibility to acute HIV-1 infection.

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Relative Dominance of Epitope-Specific Cytotoxic T-Lymphocyte Responses in Human Immunodeficiency Virus Type 1-Infected Persons with Shared HLA Alleles

Journal of Virology ◽

10.1128/jvi.75.14.6279-6291.2001 ◽

2001 ◽

Vol 75 (14) ◽

pp. 6279-6291 ◽

Cited By ~ 41

Author(s):

Cheryl L. Day ◽

Amy K. Shea ◽

Marcus A. Altfeld ◽

Douglas P. Olson ◽

Susan P. Buchbinder ◽

...

Keyword(s):

Human Immunodeficiency Virus ◽

Hiv Infection ◽

Hla Class I ◽

Class I ◽

Acute Hiv Infection ◽

Ctl Response ◽

Immunodeficiency Virus ◽

Hla Type ◽

Hiv 1 ◽

Ctl Responses

ABSTRACT Cytotoxic T lymphocytes (CTL) target multiple epitopes in human immunodeficiency virus (HIV)-infected persons, and are thought to influence the viral set point. The extent to which HLA class I allele expression predicts the epitopes targeted has not been determined, nor have the relative contributions of responses restricted by different class I alleles within a given individual. In this study, we performed a detailed analysis of the CTL response to optimally defined CTL epitopes restricted by HLA class I A and B alleles in individuals who coexpressed HLA A2, A3, and B7. The eight HIV-1-infected subjects studied included two subjects with acute HIV infection, five subjects with chronic HIV infection, and one long-term nonprogressor. Responses were heterogeneous with respect to breadth and magnitude of CTL responses in individuals of the same HLA type. Of the 27 tested epitopes that are presented by A2, A3, and B7, 25 were targeted by at least one person. However, there was wide variation in the number of epitopes targeted, ranging from 2 to 17. The A2-restricted CTL response, which has been most extensively studied in infected persons, was found to be narrowly directed in most individuals, and in no cases was it the dominant contributor to the total HIV-1-specific CTL response. These results indicate that HLA type alone does not predict CTL responses and that numerous potential epitopes may not be targeted by CTL in a given individual. These data also provide a rationale for boosting both the breadth and the magnitude of HIV-1-specific CTL responses by immunotherapy in persons with chronic HIV-1 infection.

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