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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Prevalence of seroconversion symptoms and relationship to set-point viral load: Findings from a subtype C epidemic, 1995-2009
AIDS, Volume 26, No. 2, Year 2012
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Description
OBJECTIVE:: To describe symptoms, physical examination findings, and set-point viral load associated with acute HIV seroconversion in a heterosexual cohort of HIV-discordant couples in Zambia. DESIGN:: We followed HIV serodiscordant couples in Lusaka, Zambia from 1995 to 2009 with HIV testing of negative partners and symptom inventories 3 monthly, and physical examinations annually. METHODS:: We compared prevalence of self-reported or treated symptoms (malaria syndrome, chronic diarrhea, asthenia, night sweats, and oral candidiasis) and annual physical examination findings (unilateral or bilateral neck, axillary, or inguinal adenopathy; and dermatosis) in seroconverting vs. HIV-negative or HIV-positive intervals, controlling for repeated observations, age, and sex. A composite score comprised of significant symptoms and physical examination findings predictive of seroconversion vs. HIV-negative intervals was constructed. We modeled the relationship between number of symptoms and physical examination findings at seroconversion and log set-point viral load using linear regression. RESULTS:: Two thousand, three hundred and eighty-eight HIV-negative partners were followed for a median of 18 months; 429 seroconversions occurred. Neither symptoms nor physical examination findings were reported for most seroconverters. Seroconversion was significantly associated with malaria syndrome among nondiarrheic patients [adjusted odds ratio (aOR)=4.0], night sweats (aOR=1.4), and bilateral axillary (aOR=1.6), inguinal (aOR=2.2), and neck (aOR=2.2) adenopathy relative to HIV-negative intervals. Median number of symptoms and findings was positively associated with set-point viral load (P<0.001). CONCLUSION:: Although most acute and early infections were asymptomatic, malaria syndrome was more common and more severe during seroconversion. When present, symptoms and physical examination findings were nonspecific and associated with higher set-point viremia. © 2012 Lippincott Williams & Wilkins, Inc.
Authors & Co-Authors
Sullivan, Patrick Sean
United States, Atlanta
Rollins School of Public Health
Fideli, Ülgen Semaye
United States, Bethesda
Walter Reed National Military Medical Center
Wall, Kristin Marie
United States, Atlanta
Rollins School of Public Health
Chomba, Elwyn Nachanya
Zambia, Lusaka
Zambia-emory Hiv Research Project
Vwalika, Cheswa M.
Zambia, Lusaka
Zambia-emory Hiv Research Project
Kilembe, William
Zambia, Lusaka
Zambia-emory Hiv Research Project
Tichacek, Amanda C.
United States, Atlanta
Emory University School of Medicine
Luisi, Nicole
United States, Atlanta
Rollins School of Public Health
Mulenga, Joseph
Zambia, Lusaka
Zambia National Blood Transfusion Service
Hunter, Eric
United States, Atlanta
Emory University School of Medicine
Boeras, Debrah I.
United States, Atlanta
Emory University School of Medicine
Allen, Susan A.
Zambia, Lusaka
Zambia-emory Hiv Research Project
United States, Atlanta
Emory University School of Medicine
Statistics
Citations: 27
Authors: 12
Affiliations: 5
Identifiers
Doi:
10.1097/QAD.0b013e32834ed8c8
e-ISSN:
14735571
Research Areas
Health System And Policy
Infectious Diseases
Study Design
Cross Sectional Study
Cohort Study
Case-Control Study
Study Locations
Zambia