Keet I P, Krijnen P, Koot M, Lange J M, Miedema F, Goudsmit J, Coutinho R A
Municipal Health Service, Department of Public Health and Environment, Amsterdam, The Netherlands.
AIDS. 1993 Jan;7(1):51-7. doi: 10.1097/00002030-199301000-00008.
To determine whether at the time of HIV-1 seroconversion rapid progressors to AIDS and a low CD4+ count can be distinguished by the clinical presentation of primary HIV-1 infection and serological and immunological characteristics.
Prospective cohort study on HIV-1 infection in homosexual men.
The Municipal Health Service, Amsterdam, The Netherlands.
One hundred and eight men who seroconverted for HIV-1 during follow-up.
Progression to AIDS and progression to a CD4+ lymphocyte count < 200 x 10(6)/l.
Symptomatic primary HIV infection with fever and skin rash, absence of anti-HIV core and transient HIV p24 antigenemia were independent predictors of progression to AIDS at the time of HIV-1 seroconversion. A low CD4+ count immediately after seroconversion and the calendar year were independent predictors of progression to a low CD4+ count at the time of HIV-1 seroconversion.
Even in the earliest stage of HIV-1 infection a small group of individuals at high risk for rapid progression to AIDS can be recognized by the clinical presentation of primary HIV infection, the presence of HIV p24 antigenaemia and the absence of a serological response to HIV core protein.
确定在HIV-1血清转化时，能否通过原发性HIV-1感染的临床表现以及血清学和免疫学特征来区分快速进展至艾滋病且CD4+细胞计数低的患者。
对男同性恋者中HIV-1感染进行前瞻性队列研究。
荷兰阿姆斯特丹市卫生服务局。
随访期间HIV-1血清转化的108名男性。
进展至艾滋病以及进展至CD4+淋巴细胞计数<200×10⁶/L。
有发热和皮疹的有症状原发性HIV感染、缺乏抗HIV核心抗体以及短暂的HIV p24抗原血症是HIV-1血清转化时进展至艾滋病的独立预测因素。血清转化后即刻CD4+细胞计数低以及年份是HIV-1血清转化时进展至低CD4+细胞计数的独立预测因素。
即使在HIV-1感染的最早阶段，一小部分有快速进展至艾滋病高风险的个体可通过原发性HIV感染的临床表现、HIV p24抗原血症的存在以及对HIV核心蛋白缺乏血清学反应来识别。
