Martínez P, Muñoz J, Santamaría J M, Teira R, Etxabarri S G, Miguel F, Cisterna R
Secciones de Medicina Interna, Hospital Civil de Bilbao.
Enferm Infecc Microbiol Clin. 1992 Apr;10(4):205-10.
The diagnosis of acute HIV infection must rely in the demonstration of a significant increase in antibody titers against HIV together with the timely development of clinical symptoms. The percentage of cases with symptomatic acute HIV infection is currently unknown.
We performed a retrospective review of all patients admitted to Internal Medicine and Infectious Diseases department of a General Hospital in a three-year period. The presence of HIV-antibodies was assessed by means of ELISA, indirect immunofluorescent test and Western blot technique.
Among a total number of 1110 patients, we found 10 (0.9%) that were considered as having an acute symptomatic HIV infection. Clinical presentation was as follows: mononucleosis-like syndrome, 7 patients; aseptic meningitis, 1 patient; polirradiculoneurophaty and coreoatetosis, 1 patient and esophageal candidiasis, 1 patient. Transmission of infection was heterosexual contact in 60% of cases. Four patients developed a transient skin rash, four had oral candidiasis and low platelet count was detected in 6 cases. The presence of circulating HIV antigen could be demonstrated in 7 patients, and the change in antibody titer was recorded with an 11 +/- 2 weeks span.
The incidence of symptomatic HIV acute infection was only 0.9% in our study. The high number of patients with heterosexual transmission and low platelet counts in our series is remarkable.
急性HIV感染的诊断必须依靠HIV抗体滴度显著升高以及临床症状的及时出现。目前，有症状的急性HIV感染病例的比例尚不清楚。
我们对一家综合医院内科和传染病科在三年期间收治的所有患者进行了回顾性研究。通过酶联免疫吸附测定（ELISA）、间接免疫荧光试验和蛋白质印迹技术评估HIV抗体的存在情况。
在总共1110名患者中，我们发现10例（0.9%）被认为患有急性症状性HIV感染。临床表现如下：单核细胞增多症样综合征，7例；无菌性脑膜炎，1例；多发性神经根神经炎和舞蹈手足徐动症，1例；食管念珠菌病，1例。60%的病例感染传播途径为异性接触。4例患者出现短暂皮疹，4例有口腔念珠菌病，6例检测到血小板计数低。7例患者可检测到循环HIV抗原，抗体滴度变化记录为11±2周。
在我们的研究中，有症状的HIV急性感染发病率仅为0.9%。我们系列研究中异性传播患者数量众多以及血小板计数低的情况值得关注。
