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Journal of the International AIDS Society

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Open Access 01-12-2011 | Research

Acute retroviral syndrome and high baseline viral load are predictors of rapid HIV progression among untreated Argentinean seroconverters

Authors: M Eugenia Socías, Omar Sued, Natalia Laufer, María E Lázaro, Horacio Mingrone, Daniel Pryluka, Carlos Remondegui, María I Figueroa, Carina Cesar, Ana Gun, Gabriela Turk, María B Bouzas, Ravi Kavasery, Alejandro Krolewiecki, Héctor Pérez, Horacio Salomón, Pedro Cahn, Grupo Argentino de Seroconversión Study Group

Published in: Journal of the International AIDS Society | Issue 1/2011

Abstract

Background

Diagnosis of primary HIV infection (PHI) has important clinical and public health implications. HAART initiation at this stage remains controversial.

Methods

Our objective was to identify predictors of disease progression among Argentinean seroconverters during the first year of infection, within a multicentre registry of PHI-patients diagnosed between 1997 and 2008. Cox regression was used to analyze predictors of progression (LT-CD4 < 350 cells/mm³, B, C events or death) at 12 months among untreated patients.

Results

Among 134 subjects, 74% presented with acute retroviral syndrome (ARS). Seven opportunistic infections (one death), nine B events, and 10 non-AIDS defining serious events were observed. Among the 92 untreated patients, 24 (26%) progressed at 12 months versus three (7%) in the treated group (p = 0.01). The 12-month progression rate among untreated patients with ARS was 34% (95% CI 22.5-46.3) versus 13% (95% CI 1.1-24.7) in asymptomatic patients (p = 0.04). In univariate analysis, ARS, baseline LT-CD4 < 350 cells/mm³, and baseline and six-month viral load (VL) > 100,000 copies/mL were associated with progression. In multivariate analysis, only ARS and baseline VL > 100,000 copies/mL remained independently associated; HR: 8.44 (95% CI 0.97-73.42) and 9.44 (95% CI 1.38-64.68), respectively.

Conclusions

In Argentina, PHI is associated with significant morbidity. HAART should be considered in PHI patients with ARS and high baseline VL to prevent disease progression.

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Title: Acute retroviral syndrome and high baseline viral load are predictors of rapid HIV progression among untreated Argentinean seroconverters
Authors: M Eugenia Socías
Omar Sued
Natalia Laufer
María E Lázaro
Horacio Mingrone
Daniel Pryluka
Carlos Remondegui
María I Figueroa
Carina Cesar
Ana Gun
Gabriela Turk
María B Bouzas
Ravi Kavasery
Alejandro Krolewiecki
Héctor Pérez
Horacio Salomón
Pedro Cahn
Grupo Argentino de Seroconversión Study Group
Publication date: 01-12-2011
Publisher: BioMed Central
Published in: Journal of the International AIDS Society / Issue 1/2011
Electronic ISSN: 1758-2652
DOI: https://doi.org/10.1186/1758-2652-14-40

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