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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Self-citation
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Background
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BackgroundInfluential
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Self-citation
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Background
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Self-citation
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Background
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Influential
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Self-citation
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“More than 90% of cases of acute HIV infection go undiagnosed despite the fact that more than 50% of persons with the disease are symptomatic (2).”
Background
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“Duration of symptoms (days)* 14 (7-21) 15 (10-20) 13 (7-17) 18 (9-22) 0.”
Ex Vivo Modeling of Oral HIV Transmission in Human Palatine Tonsil
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“Clinical evaluations of HIVinfected patients and experimental simian immunodeficiency virus (SIV) infections in rhesus macaques have clearly shown that high-level disseminated infection can occur within a few weeks of primary virus exposure (Schacker et al. 1996).”
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Chronic Meningitis
Thakur, K. T., & Wilson, M. R. (2018) · CONTINUUM Lifelong Learning in Neurology · doi:10.1212/con.0000000000000664 · Cited by 35
Analysis of protein kinase C theta inhibitors for the control of HIV-1 replication in human CD4+ T cells reveals an effect on retrotranscription in addition to viral transcription
Bermejo, M., López‐Huertas, M. R., Hedgpeth, J., Mateos, E., Rodríguez-Mora, S., Maleno, M. J., Plana, M., Swindle, J., Alcamı́, J., & Coiras, M. (2015) · Biochemical Pharmacology · doi:10.1016/j.bcp.2015.02.009 · Cited by 24
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Submandibular Salivary Proteases: Lack of a Role in Anti-HIV Activity
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Alcohol Enhances HIV Type 1 Infection in Normal Human Oral Keratinocytes by Up-regulating Cell-Surface CXCR4 Coreceptor
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Background
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A Novel Acute Retroviral Syndrome Severity Score Predicts the Key Surrogate Markers for HIV-1 Disease Progression
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Background
Clinical Features of Acute Retroviral Syndrome Differ by Route of Infection but Not by Gender and Age
Vanhems, P., Routy, J., Hirschel, B. J., Baratin, D., Vora, S., Maenza, J. R., Carr, A., TREPO, C. G., Touraine, J. L., Gillibert, R.-P., et al. (2002) · JAIDS Journal of Acquired Immune Deficiency Syndromes · doi:10.1097/00126334-200211010-00007 · Cited by 21
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Result
Induction of Human Immunodeficiency Virus Type 1 (HIV-1)-Specific T-Cell Responses in HIV Vaccine Trial Participants Who Subsequently Acquire HIV-1 Infection
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Background
Oral Sex and HIV Transmission
&NA; (1997) · Journal of Acquired Immune Deficiency Syndromes & Human Retrovirology · doi:10.1097/00042560-199704150-00012 · Cited by 21

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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