Cited by 705HIV/AIDS Research and InterventionsHIV Research and TreatmentHIV-related health complications and treatments

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Clinical and epidemiologic features of primary HIV infection.

Schacker, Timothy, Collier, Ann C., Hughes, James, Shea, Theresa, Corey, Lawrence·1996·Annals of Internal Medicine

DOI 10.7326/0003-4819-125-4-199608150-00001

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Abstract

BACKGROUND: The acute clinical events surrounding the acquisition of human immunodeficiency virus (HIV) have not been well characterized. OBJECTIVE: To further define the clinical and epidemiologic presentation of primary HIV infection. DESIGN: Descriptive cohort study. SETTING: University research clinic. PATIENTS: 46 adults (43 men and 3 women) with primary HIV infection who enrolled in the study a median of 51 days after HIV seroconversion. MEASUREMENTS: Documentation of recent HIV seroconversion. Standardized collection of demographic characteristics and sexual contact history, results of tests for HIV RNA, HIV culture, and T-cell subsets. RESULTS: 41 of 46 patients (89%) developed an acute retroviral syndrome. Primary HIV infection was infrequently diagnosed at the initial medical encounter, even in persons enrolled in routine HIV screening programs. Median numbers of sexual partners 6 months and 1 month before acquisition of HIV were three and one, respectively; 21 patients (46%) reported having had only one partner in the month before seroconversion. Of the 12 patients who could identify the precise date of and activity leading to seroconversion, 4 reported having only oral-genital contact. CONCLUSIONS: Primary HIV infection causes a recognizable clinical syndrome that is often underdiagnosed, even in persons enrolled in a program of routine surveillance for HIV infection. Frequency of sexual contact and overall numbers of sexual partners in this group of homosexual men who acquired HIV were markedly lower than those seen a decade ago. Acquisition of HIV does occur, even in persons with relatively few sexual partners. Increased attention to oral-genital contact as a means of acquiring HIV appears to be warranted.

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Items 101–200 of 705

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Iversen, A. K. N., Larsen, A. R., Jensen, T., Fugger, L. H., Balslev, U., Wahl, S., Gerstoft, J., Mullins, J. I., & Skinhøj, P. (1998) · The Journal of Infectious Diseases · doi:10.1086/515266 · Cited by 92
“Since in our study, nearly two-thirds of HIV-positive women carried detectable genital vims loads, our data and the finding of the significant role of oral exposure in transmission of HIV [19] and simian immunodeficiency vims [20] raise further concerns for the HIV transmission risk during oral sex with women.”
Result
The Relation Between Symptoms, Viral Load, and Viral Load Set Point in Primary HIV Infection
Kelley, C. F., Barbour, J. D., & Hecht, F. M. (2007) · JAIDS Journal of Acquired Immune Deficiency Syndromes · doi:10.1097/qai.0b013e318074ef6e · Cited by 93
“(J Acquir Immune Defic Syndr 2007;45:445–448) P rimary HIV infection (PHI) can include a self-limited period of flu-like symptoms occurring during the first weeks of HIV-1 infection.(1) It is associated with peak levels of HIV-1 RNA viremia, which subsequently decline until reaching a set point, where levels remain fo…”
Background
Combined Effect of CCR5-Δ32 Heterozygosity and the CCR5 Promoter Polymorphism −2459 A/G on CCR5 Expression and Resistance to Human Immunodeficiency Virus Type 1 Transmission
Hladik, F., Liu, H., Speelmon, E. C., et al. (2005) · Journal of Virology · doi:10.1128/jvi.79.18.11677-11684.2005 · Cited by 93
“(50), HIV-1 plasma RNA reverse transcription-PCR (Amplicor HIV-1 Monitor;”
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“Definition of Typical and Atypical Acute Retroviral Syndrome First, we extensively reviewed the literature on reported signs and symptoms associated with PHI (Supplementary Appendices 2–4) [1–6, 8–13].”
Background
Sexual Transmission During the Incubation Period of Primary HIV Infection
Pilcher, C. D., Eron, J. J., Vemazza, P. L., et al. (2001) · JAMA · doi:10.1001/jama.286.14.1713 · Cited by 92
Decision support and safety of clinical environments
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Polymorphisms in toll-like receptor 4 and toll-like receptor 9 influence viral load in a seroincident cohort of HIV-1-infected individuals
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“Enrollment criteria have been previously reported in detail elsewhere [36].”
Background
Antiretroviral Postexposure Prophylaxis After Sexual, Injection-Drug Use, or Other Nonoccupational Exposure to HIV in the United States
Smith, D. K., Grohskopf, L. A., Black, R. J., Auerbach, J. D., & Veronese, F. D. M. (2005) · Cited by 94
The Care of Persons with Recent Sexual Exposure to HIV
Katz, M. H., & Gerberding, J. L. (1998) · Annals of Internal Medicine · doi:10.7326/0003-4819-128-4-199802150-00012 · Cited by 91
“Diagnosing primary infection has emerged as a high priority because treatment during this period may decrease the total body burden of virus and delay or prevent the onset of immunodeficiency (19, 64, 65).”
BackgroundInfluential
Antiretroviral therapy interruption guided by CD4 cell counts and plasma HIV-1 RNA levels in chronically HIV-1-infected patients
Ruiz, L., Paredes, R., Melis, G. G., Romeu, J., Domingo, P., Pérez‐Álvarez, N., Tambussi, G., Llibre, J. M., Martínez‐Picado, J., Vidal, F., et al. (2006) · AIDS · doi:10.1097/qad.0b013e328011033a · Cited by 88
Neurological Symptoms during Primary Human Immunodeficiency Virus (HIV) Infection Correlate with High Levels of HIV RNA in Cerebrospinal Fluid
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HIV infection in Haiti: natural history and disease progression
Deschamps, M.-M., Fitzgerald, D. W., Pape, J. W., et al. (2000) · AIDS · doi:10.1097/00002030-200011100-00014 · Cited by 85
“The de®nition of the acute retroviral syndrome followed previously published reports [5].”
Background
HERPES SIMPLEX VIRUS–2 INFECTION
Schomogyi, M., Wald, A., & Corey, L. (1998) · Infectious Disease Clinics of North America · doi:10.1016/s0891-5520(05)70408-6 · Cited by 85
Self-citation
Compartmentalization of Human Immunodeficiency Virus Type 1 between Blood Monocytes and CD4+T Cells during Infection
Fulcher, J. A., Hwangbo, Y., Zioni, R., Nickle, D. C., Lin, X., Heath, L., Mullins, J. I., Corey, L., & Zhu, T. (2004) · Journal of Virology · doi:10.1128/jvi.78.15.7883-7893.2004 · Cited by 81
“this primary infection cohort were reported previously (75, 76).”
BackgroundSelf-citation
Missed opportunities for diagnosing primary HIV infection
Sudarshi, D., Pao, D., Murphy, G., et al. (2007) · Sexually Transmitted Infections · doi:10.1136/sti.2007.026963 · Cited by 84
“these symptoms are non-specific in nature and may mimic many common febrile illnesses.(8) 9”
Background
Early immune activation in gut-associated and peripheral lymphoid tissue during acute HIV infection
Nilsson, J., Loes, S. K., Granath, A., Sönnerborg, A. B., Goh, L., & Andersson, J. (2007) · AIDS · doi:10.1097/qad.0b013e3280117204 · Cited by 83
“The onset of clinical symptoms, which usually occurs approximately 12–14 days [2] after primary infection generally coincides with extremely high viral replication [3–5].”
Background
Impact of Depression and Inflammation on the Progression of HIV Disease
Rivera-Rivera, Y., & Vázquez-Santiago, F. J. (2016) · Journal of Clinical & Cellular Immunology · doi:10.4172/2155-9899.1000423 · Cited by 87
“Early HIV diagnosis is often difficult because of the onset of non-specific and general symptoms [6,7].”
Clinical presentation and diagnosis of primary HIV-1 infection
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“The median duration of symptoms is 14 days [23].”
BackgroundInfluentialSelf-citation
Mutation of HIV-1 Genomes in a Clinical Population Treated with the Mutagenic Nucleoside KP1461
Mullins, J. I., Heath, L., Hughes, J. P., Kicha, J., Styrchak, S. M., Wong, K. G., Rao, U., Hansen, A. R., Harris, K. S., Laurent, J.-P., et al. (2011) · PLoS ONE · doi:10.1371/journal.pone.0015135 · Cited by 77
“While no similarly advanced, ART-experienced subjects were available with the short (,2 m) sampling intervals evaluated in the Phase IIa trial, we were able to closely match the sampling intervals in a cohort of longitudinally studied volunteers initially enrolled in primary HIV infection [27], and infected for an ave…”
BackgroundMethodSelf-citation
Highly Active Antiretroviral Treatment Initiated Early in the Course of Symptomatic Primary HIV‐1 Infection: Results of the ANRS 053 Trial
Hoen, B., Dumon, B., Harzic, M., et al. (1999) · The Journal of Infectious Diseases · doi:10.1086/315002 · Cited by 77
“Symptomatic primary human immunodeficiency virus type 1 (HIV-1) infection (PHI) occurs in 150% of patients infected by HIV-1 and is associated with a poor prognosis [1].”
Background
Substance use is a risk factor for neurocognitive deficits and neuropsychiatric distress in acute and early HIV infection
The TMARC Group, Weber, E., Morgan, E. E., Iudicello, J. E., Blackstone, K., Grant, I., Ellis, R. J., Letendre, S. L., Little, S. J., Morris, S., et al. (2012) · Journal of NeuroVirology · doi:10.1007/s13365-012-0141-y · Cited by 75
“…et al. 1996; Zetola and Pilcher 2007), which can include a wide range of virologic, immunologic, and neurological complications (e.g., meningitis; Schacker et al. 1996), the severity of which has been associated with adverse complications during chronic infection, such as high levels of HIV…”
BackgroundInfluential
Rapid dissemination of SIV following oral inoculation.
Milush, J. M., Kosub, D. A., Marthas, M. L., Schmidt, K. A., Scott, F., Wozniakowski, A., Brown, C. R., Westmoreland, S. V., & Sodora, D. L. (2004) · PubMed · Cited by 76
Viruses, parkinsonism and Parkinson’s disease: the past, present and future
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Cross-Sectional Detection of Acute HIV Infection: Timing of Transmission, Inflammation and Antiretroviral Therapy
Gay, C. L., Dibben, O., Anderson, J. A., Stacey, A., Mayo, A., Norris, P. J., Kuruc, J. D., Salazar-Gonzalez, J. F., Li, H., Keele, B. F., et al. (2011) · PLoS ONE · doi:10.1371/journal.pone.0019617 · Cited by 71
“Findings are consistent with prior studies with well-described HIV exposure dates,[31,32] and support use of 14 days prior to symptom onset to estimate HIV transmission dates.”
Result
Injectable Contraceptive Use and Genital Ulcer Disease during the Early Phase of HIV‐1 Infection Increase Plasma Virus Load in Women
Lavreys, L., Baeten, J. M., Kreiss, J. K., et al. (2004) · The Journal of Infectious Diseases · doi:10.1086/380974 · Cited by 71
“GUD is an important cofactor for HIV-1 acquisition [44, 45] and has also been described as a clinical feature of acute HIV-1 illness [46] (e.”
Background
Early Human Immunodeficiency Virus (HIV) Infection in the HIV Network for Prevention Trials Vaccine Preparedness Cohort: Risk Behaviors, Symptoms, and Early Plasma and Genital Tract Virus Load
Celum, C., Buchbinder, S. P., Donnell, D. J., et al. (2001) · The Journal of Infectious Diseases · doi:10.1086/317658 · Cited by 71
On the analysis of viral load endpoints in HIV vaccine trials
Hudgens, M. G., Hoering, A., & Self, S. G. (2003) · Statistics in Medicine · doi:10.1002/sim.1394 · Cited by 70
“Based on published estimates on variability of HIV-1 RNA measurements [38] and data collected on acute and recent HIV1 infections [39, 40] (Jim Hughes, personal communication), parameter values were set to =4:50, 2 B =0:33, and 2 W =0:07, all on a log10 scale.”
Background
Public Health Rationale for Rapid Nucleic Acid or p24 Antigen Tests for HIV
Pilcher, C. D., Christopoulos, K. A., & Golden, M. R. (2010) · The Journal of Infectious Diseases · doi:10.1086/650393 · Cited by 68
“Some studies indicate that many patients with acute HIV infection seek medical care for their symptoms [65, 66] and that, when they do, it is usually in a primary care, urgent care, or other drop-in type of clinic.”
Background
Lack of Resistance to Integrase Inhibitors among Antiretroviral-Naive Subjects with Primary HIV-1 Infection, 2007–2013
Stekler, J. D., McKernan, J. L., Milne, R. S., et al. (2014) · Antiviral Therapy · doi:10.3851/imp2780 · Cited by 66
“Subjects for this analysis were enrolled within 30 days of HIV infection, estimated to be the date of onset of seroconversion symptoms [15] or, for asymptomatic subjects, the midpoint between the last negative and first positive HIV tests.”
MethodSelf-citation
Increased blood-brain barrier permeability in neuro-asymptomatic HIV-1-infected individualscorrelation with cerebrospinal fluid HIV-1 RNA and neopterin levels
Andersson, L. (2001) · Journal of NeuroVirology · doi:10.1080/135502801753248123 · Cited by 66
Continuing intrathecal immunoactivation despite two years of effective antiretroviral therapy against HIV-1 infection
Abdulle, S., Hagberg, L., Svennerholm, B., et al. (2002) · AIDS · doi:10.1097/00002030-200211080-00006 · Cited by 65
“HIV-1 infects the central nervous system (CNS) early in the infectious course [4,5] and triggers an immune response that can be measured by increased CSF levels of neopterin and 2-microglobulin [6,7].”
Background
The lymph node in HIV pathogenesis
Lederman, M. M., & Margolis, L. B. (2008) · Seminars in Immunology · doi:10.1016/j.smim.2008.06.001 · Cited by 67
“Acute HIV infection is often associated with generalized lymph node enlargement [19,20], and with time, it may be found in most patients if looked for carefully [20].”
Background
The Use of Nanotrap Particles Technology in Capturing HIV-1 Virions and Viral Proteins from Infected Cells
Jaworski, E. M., Saifuddin, M., Sampey, G. C., Shafagati, N., Duyne, R. V., Iordanskiy, S., Kehn‐Hall, K., Liotta, L. A., Petricoin, E. F., Young, M., et al. (2014) · PLoS ONE · doi:10.1371/journal.pone.0096778 · Cited by 65
“aware of their HIV-1 positive status [8,10,11].”
Acute Human Immunodeficiency Virus Infection in Patients Presenting to an Urban Urgent Care Center
Pincus, J. M., Crosby, S. S., Losina, E., King, E. R., LaBelle, C. T., & Freedberg, K. A. (2003) · Clinical Infectious Diseases · doi:10.1086/379772 · Cited by 63
“We used very broad entry criteria to determine a lower prevalence estimate for our population, a cohort of lower risk than those in previous studies of acute HIV infection from referral populations [6, 18, 21].”
Method
Viral Dynamics during Primary Simian Immunodeficiency Virus Infection: Effect of Time-Dependent Virus Infectivity
Vaidya, N. K., Ribeiro, R. M., Miller, C. J., & Perelson, A. S. (2010) · Journal of Virology · doi:10.1128/jvi.02284-09 · Cited by 62
Human Submandibular Saliva Inhibits Human Immunodeficiency Virus Type 1 Infection by Displacing Envelope Glycoprotein gp120 from the Virus
Nagashunmugam, T., Malamud, D., Davis, C., et al. (1998) · The Journal of Infectious Diseases · doi:10.1086/314511 · Cited by 63
“[14] studied high-risk individuals and identified oral sex as the sole risk factor in 4 subjects who seroconverted.”
Background
The cutaneous manifestations of HIV infection
Garman, M., & Tyring, S. K. (2002) · Dermatologic Clinics · doi:10.1016/s0733-8635(01)00011-0 · Cited by 63
Retroviral Rebound Syndrome after Cessation of Suppressive Antiretroviral Therapy in Three Patients with Chronic HIV Infection
Colven, R., Harrington, R. D., Spach, D. H., Cohen, C. J., & Hooton, T. M. (2000) · Annals of Internal Medicine · doi:10.7326/0003-4819-133-6-200009190-00010 · Cited by 63
“Aseptic meningitis also occurs in nearly one quarter of patients with primary retroviral syndrome who seek medical attention (1).”
Background
Serological testing algorithm shows rising HIV incidence in a UK cohort of men who have sex with men: 10 years application
Fisher, M., Pao, D., Murphy, G., Dean, G. L., McElborough, D., Homer, G., & Parry, J. V. (2007) · AIDS · doi:10.1097/qad.0b013e3282ef9fed · Cited by 62
“Although 40–90% of recent infections are symptomatic, the clinical manifestations are usually non-specific [7] and either do not present or go unrecognized by healthcare providers [8,9].”
Background
Health Department Collaboration with Emergency Departments as a Model for Public Health Programs among at-Risk Populations
Lyons, M. S., Lindsell, C. J., Ledyard, H. K., et al. (2005) · Public Health Reports · doi:10.1177/003335490512000307 · Cited by 62
Incubation Time of Acute Human Immunodeficiency Virus (HIV) Infection and Duration of Acute HIV Infection Are Independent Prognostic Factors of Progression to AIDS
Vanhems, P., Hirschel, B. J., Phillips, A. N., et al. (2000) · The Journal of Infectious Diseases · doi:10.1086/315687 · Cited by 61
“[2], 2–3 weeks for Quin [6], and 3–6 weeks for Clark et al.”
Background
Cost-Effectiveness of Pooled Nucleic Acid Amplification Testing for Acute HIV Infection after Third-Generation HIV Antibody Screening and Rapid Testing in the United States: A Comparison of Three Public Health Settings
Hutchinson, A. B., Patel, P., Sansom, S. L., Farnham, P. G., Sullivan, T. J., Bennett, B., Kerndt, P. R., Bolan, R., Heffelfinger, J. D., Prabhu, V. S., et al. (2010) · PLoS Medicine · doi:10.1371/journal.pmed.1000342 · Cited by 59
“In sensitivity analysis, we estimated the impact of AHI detection on the basis of symptoms by estimating the proportion of AHI cases that are symptomatic, seek care, and are correctly diagnosed, and removing those estimated symptomatic cases from the AHI cases that could be identified through pooled NAAT screening for…”
Method
Rapid Rise in Detection of Human Papillomavirus (HPV) Infection Soon After Incident HIV Infection Among South African Women
Wang, C., Wright, T. C., Denny, L., et al. (2011) · The Journal of Infectious Diseases · doi:10.1093/infdis/jiq083 · Cited by 59
“Primary HIV infection is characterized by an acute symptomatic period inmost incident infections [11–13].”
Background
Cell phone based colorimetric analysis for point-of-care settings
Coleman, B., Coarsey, C., & Asghar, W. (2019) · The Analyst · doi:10.1039/c8an02521e · Cited by 57
Sexual Transmission of HIV
(1997) · New England Journal of Medicine · doi:10.1056/nejm199709113371123 · Cited by 58
Acute retroviral syndrome and high baseline viral load are predictors of rapid HIV progression among untreated Argentinean seroconverters
Socias, M. E., Sued, O. G., Laufer, N., Lázaro, M. E., Mingrone, H., Pryluka, D., Remondegui, C., Figueroa, M. I., César, C., Gun, A., et al. (2011) · Journal of the International AIDS Society · doi:10.1186/1758-2652-14-40 · Cited by 57
“In our cohort, the proportion of patients with symptomatic disease was similar to previous series [13,17,21,22].”
Result
Intermediate-Size Trials for the Evaluation of HIV Vaccine Candidates: A Workshop Summary
RIDA, W. N., Fast, P., Hoff, R., et al. (1997) · Journal of Acquired Immune Deficiency Syndromes & Human Retrovirology · doi:10.1097/00042560-199711010-00009 · Cited by 57
Proviral HIV-1 DNA in Gingival Crevicular Fluid of HIV-1-infected Patients in Various Stages of HIV Disease
Matičič, M., Poljak, M., Kramar, B., et al. (2000) · Journal of Dental Research · doi:10.1177/00220345000790071101 · Cited by 56
Acute Retroviral Syndrome Is Associated With High Viral Burden, CD4 Depletion, and Immune Activation in Systemic and Tissue Compartments
Crowell, T. A., Colby, D. J., Pinyakorn, S., Fletcher, J. L. K., Kroon, E., Schuetz, A., Krebs, S. J., Slike, B. M., Leyre, L., Chomont, N., et al. (2018) · Clinical Infectious Diseases · doi:10.1093/cid/cix1063 · Cited by 55
Most Highly Exposed Seronegative Men Lack HIV-1-Specific, IFN-γ-Secreting T Cells
Hladik, F., Desbien, A. L., Lang, J., et al. (2003) · The Journal of Immunology · doi:10.4049/jimmunol.171.5.2671 · Cited by 55
“HIV-1 infection was excluded by the following tests performed at the screening visit and on study day 0: HIV1/2 ELISA and Western blot (37), HIV-1 plasma RNA RT-PCR (Amplicor HIV-1 Monitor; Roche, Branchburg, NJ) (38), and PBMC DNA PCR (39).”
Method
The Effects of Early Antiretroviral Therapy and Its Discontinuation on the HIV-Specific Antibody Response
Killian, M. S., Norris, P. J., Rawal, B. D., et al. (2006) · AIDS Research and Human Retroviruses · doi:10.1089/aid.2006.22.640 · Cited by 55
Clinical Management of Acute HIV Infection: Best Practice Remains Unknown
Bell, S. K., Little, S. J., & Rosenberg, E. S. (2010) · The Journal of Infectious Diseases · doi:10.1086/655655 · Cited by 53
“Because up to a quarter of patients may present with aseptic meningitis [25, 28], treatment for this indication may affect a substantial”
Background
Sex differences in soluble markers vary before and after the initiation of antiretroviral therapy in chronically HIV-infected individuals
Krebs, S. J., Slike, B. M., Sithinamsuwan, P., Allen, I. E., Chalermchai, T., Tipsuk, S., Phanuphak, N., Jagodzinski, L. L., Kim, J. H., Ananworanich, J., et al. (2016) · AIDS · doi:10.1097/qad.0000000000001096 · Cited by 53
Acute HIV Syndrome after Discontinuation of Antiretroviral Therapy in a Patient Treated before Seroconversion
Daar, E. S., Bai, J., Hausner, M. A., Majchrowicz, M., Tamaddon, M., & Giorgi, J. V. (1998) · Annals of Internal Medicine · doi:10.7326/0003-4819-128-10-199805150-00005 · Cited by 53
Roles of Target Cells and Virus-Specific Cellular Immunity in Primary Simian Immunodeficiency Virus Infection
Regoes, R. R., Antia, R., Garber, D. A., et al. (2004) · Journal of Virology · doi:10.1128/jvi.78.9.4866-4875.2004 · Cited by 52
“The viremia in primary human immunodeficiency virus (HIV) infection is characterized by a steep initial increase rising to a peak after a few weeks, a postpeak decline, and an ultimate attainment of the so-called viral load set point (2, 4, 14, 15, 24, 25) (Fig.”
Background
Trends of HIV-1 seroincidence among HIV-1 sentinel surveillance groups in Cambodia, 1999-2002.
Saphonn, V., Parekh, B., Dobbs, T. L., et al. (2005) · PubMed · Cited by 52
Oral epithelial cells are susceptible to cell-free and cell-associated HIV-1 infection in vitro
Moore, J., Rahemtulla, F. G., Kent, L. W., et al. (2003) · Virology · doi:10.1016/s0042-6822(03)00283-6 · Cited by 52
“Further, epidemiological studies have reported transmission of the virus after oral–genital contact only (Keet et al., 1992; Rozenbaum et al., 1988; Schacker et al., 1996).”
Background
Screening for Acute HIV Infection: Lessons Learned
Stekler, J. D., Maenza, J. R., Stevens, C. E., et al. (2007) · Clinical Infectious Diseases · doi:10.1086/510747 · Cited by 50
“These cases also demonstrate the importance of recognizing symptoms associated with acute HIV infection, because the majority of newly infected individuals have symptoms beginning a median of 10 days following acquisition [10].”
BackgroundSelf-citation
Rational use of computerized protocols in the intensive care unit.
Morris, A. H. (2001) · Critical Care · doi:10.1186/cc1041 · Cited by 50
“Even when the healthcare community understands the proper approach, compliance of physicians with evidence-based treatments or guidelines is low across a broad range of healthcare topics [20,85–89].”
Background
Heterozygosity for a defective gene for CC chemokine receptor 5 is not the sole determinant for the immunologic and virologic phenotype of HIV-infected long-term nonprogressors.
Cohen, O. J., Vaccarezza, M., Lam, G. K. W., Baird, B., Wildt, K. F., Murphy, P. M., Zimmerman, P. A., Nutman, T. B., Fox, C. H., Hoover, S., et al. (1997) · Journal of Clinical Investigation · doi:10.1172/jci119682 · Cited by 47
“Data regarding the lower levels of plasma viremia 9–18 mo after seroconversion in CCR5-D32 heterozygotes (28) are compelling, given the prognostic value of this measurement (40, 41).”
Background
Despite being highly diverse, immunovirological status strongly correlates with clinical symptoms during primary HIV-1 infection: a cross-sectional study based on 674 patients enrolled in the ANRS CO 06 PRIMO cohort
Ghosn, J., Deveau, C., Chaix, M., et al. (2010) · Journal of Antimicrobial Chemotherapy · doi:10.1093/jac/dkq035 · Cited by 49
Rapid dissemination of a pathogenic simian/human immunodeficiency virus to systemic organs and active replication in lymphoid tissues following intrarectal infection
Miyake, A., Ibuki, K., Enose, Y., Suzuki, H., Horiuchi, R., Motohara, M., Saito, N., Nakasone, T., Honda, M., Watanabe, T., et al. (2006) · Journal of General Virology · doi:10.1099/vir.0.81307-0 · Cited by 45
“The identity of the cells holding this proviral DNA was not clear, but they might represent a reservoir pool of virus until the development of AIDS.”
BackgroundInfluential
Longitudinal Assessment of Changes in HIV-Specific Effector Activity in HIV-Infected Patients Starting Highly Active Antiretroviral Therapy in Primary Infection
Alter, G., Hatzakis, G., Tsoukas, C. M., Pelley, K., Rouleau, D., LeBlanc, R. P., Baril, J.-G., Dion, H., Lefebvre, E. A., Thomas, R., et al. (2003) · The Journal of Immunology · doi:10.4049/jimmunol.171.1.477 · Cited by 48
Contribution of Immunological and Virological Factors to Extremely Severe Primary HIV Type 1 Infection
Dalmau, J., Puertas, M. C., Azuara, M., Mariño, A., Frahm, N., Mothe, B., Izquierdo‐Useros, N., Buzón, M. J., Paredes, R., Matas, L., et al. (2008) · Clinical Infectious Diseases · doi:10.1086/595704 · Cited by 45
“host’s initial adaptive immune response [1, 2].”
Human Immunodeficieny Virus Pathogenesis and Prospects for Immune Control in Patients with Established Infection
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Chou, R., Selph, S., Dana, T., Bougatsos, C., Zakher, B., Blazina, I., & Korthuis, P. T. (2012) · Annals of Internal Medicine · doi:10.7326/0003-4819-157-10-201211200-00007 · Cited by 46
Elevated Levels of Innate Immune Modulators in Lymph Nodes and Blood Are Associated with More-Rapid Disease Progression in Simian Immunodeficiency Virus-Infected Monkeys
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Background
Surveillance for Incident HIV Infection: New Technology and New Opportunities
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Background
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“All subjects were enrolled within 240 days after HIV infection, estimated to be the date of onset of seroconversion symptoms 22 or, for asymptomatic subjects, the midpoint between the last negative and first positive HIV tests.”
Self-citation
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Oral HIV-exposure elicits mucosal HIV-neutralizing antibodies in uninfected men who have sex with men
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Background
Acute HIV-1 infection is highly prevalent in Ugandan adults with suspected malaria
Bebell, L. M., Pilcher, C. D., Dorsey, G., Havlir, D. V., Kamya, M. R., Busch, M. P., Williams, J. D., Nugent, C. T., Bentsen, C. G., Rosenthal, P. J., et al. (2010) · AIDS · doi:10.1097/qad.0b013e32833bb732 · Cited by 43
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Background
The cost-effectiveness of symptom-based testing and routine screening for acute HIV infection in men who have sex with men in the USA
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BackgroundInfluential
HIV INFECTION–ASSOCIATED INFLAMMATORY MUSCULOSKELETAL DISORDERS
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Background
Hepatitis C and HIV Infections: Implications for Clinical Care in Injection Drug Users
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Background
Antiretroviral treatment of central nervous system HIV‐1 infection: a review
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Background
Effects of antiretroviral treatment on blood–brain barrier integrity and intrathecal immunoglobulin production in neuroasymptomatic HIV‐1‐infected patients
Abdulle, S., Hagberg, L., & Gisslén, M. (2005) · HIV Medicine · doi:10.1111/j.1468-1293.2005.00281.x · Cited by 41
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Self-citation
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BackgroundInfluential
Most adults seek urgent healthcare when acquiring HIV-1 and are frequently treated for malaria in coastal Kenya
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Evaluation of HIV testing recommendations in specialty guidelines for the management of HIV indicator conditions
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Cells producing residual viremia during antiretroviral treatment appear to contribute to rebound viremia following interruption of treatment
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Self-citation
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Background
Therapy for Human Immunodeficiency Virus Infection — What Have We Learned?
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Self-citation

Authors: Schacker, T., Collier, A. C., Hughes, J., Shea, T., & Corey, L.
Affiliations: University of Washington (US)
Corresponding author: Schacker, Timothy
ORCID: Schacker, Timothy
Collier, Ann C.
Corey, Lawrence
Venue: Annals of Internal Medicine
Publisher: American College of Physicians
Published: 1996-08-15
Volume: 125
Issue: 4
Pages: 257-264
ISSN: 0003-4819 (ISSN-L)
1539-3704
DOI: 10.7326/0003-4819-125-4-199608150-00001
OpenAlex: W2008972159
Cited by: 703
References: 0
Citations by year: 2026: 3 · 2025: 3 · 2024: 6 · 2023: 9 · 2022: 9 · 2021: 9 · 2020: 12 · 2019: 15 · 2018: 17 · 2017: 17 · 2016: 20 · 2015: 21 · 2014: 31 · 2013: 33 · 2012: 32
FWCI: 28.00
Type: journal article
Language: en
Open access: closed
Licence: www.acpjournals.org/journal/aim/text-and-data-mining (tdm)
Locations: Annals of Internal Medicine (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health (n01ai045206-013)
National Institute of Allergy and Infectious Diseases (AI 27757, AI-45206, P30AI027757)
Topics: Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
Life Sciences › Immunology and Microbiology › Virology › HIV Research and Treatment
Health Sciences › Medicine › Infectious Diseases › HIV-related health complications and treatments
Keywords: primary HIV infection, acute retroviral syndrome, HIV seroconversion, underdiagnosis, sexual partners, oral-genital contact, gay men, HIV transmission, T cell subsets, HIV RNA
MeSH terms: Adult, Female, HIV, HIV Seropositivity, Homosexuality, Humans, Male, Risk Factors, RNA, Viral, Time Factors, United States, Washington, HIV Infections, Polymerase Chain Reaction, HIV Core Protein p24, CD4 Lymphocyte Count

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Clinical and epidemiologic features of primary HIV infection.

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