Acute symptomatic HIV infection. Report of 10 cases

BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.