ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2018
Acute Retroviral Syndrome Is Associated With High Viral Burden, CD4 Depletion, and Immune Activation in Systemic and Tissue Compartments.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 2 of them syntheses that pooled it.
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Who cites it
29 citing papers in PubMed, 2 syntheses or guidelines pooled it, 52 citations in OpenAlex.
- Initiation of Antiretroviral Therapy during Primary HIV Infection: Effects on the Latent HIV Reservoir, Including on Analytic Treatment Interruptions.AIDS reviews · 2020Pooled it
- Guideline
- Recommendations from the 2nd Consensus Workshop on Analytical Treatment Interruption in HIV Research Trials.The lancet. HIV · 2026Article
- A psychometric assessment of the Patient Health Questionnaire-9 for people living with acutely-treated HIV in Thailand.Psychiatry research communications · 2026Article
- Comparison of clinical characteristics in acute and early HIV-1 infection across different subtypes: a hospital-based cohort study.Frontiers in microbiology · 2026Article
- Primary HIV-1 infection presenting with nephrotic-range proteinuria and severe acute kidney injury mimicking imported Lassa fever.Infection · 2025Article
- The utility of nonhuman primate models for understanding acute HIV-1 infection.Current opinion in HIV and AIDS · 2025Review
- Acute HIV-1 Infection: Paradigm and Singularity.Viruses · 2025Review
- Dynamics of the blood plasma proteome during hyperacute HIV-1 infection.Nature communications · 2024Article
- Central Nervous System Effects of Early HIV Infection and Consequences of Antiretroviral Therapy Initiation during Acute HIV.Viruses · 2024Review
- HLA-A*23 Is Associated With Lower Odds of Acute Retroviral Syndrome in Human Immunodeficiency Virus Type 1 Infection: A Multicenter Sub-Saharan African Study.Open forum infectious diseases · 2024Article
- Acute Hepatitis due to Primary Human Immunodeficiency Virus Infection.Open forum infectious diseases · 2024Article
- Distinct mucosal and systemic immunological characteristics in transgender women potentially relating to HIV acquisition.JCI insight · 2023Article
- Mimics of Monkeypox: Considerations for the emergency medicine clinician.The American journal of emergency medicine · 2023Review
- Immunological, Cognitive, and Psychiatric Outcomes After Initiating Efavirenz- and Dolutegravir-based Antiretroviral Therapy During Acute Human Immunodeficiency Virus Infection.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Article
- The Peculiarity of Infection and Immunity Correlated with Guillain-Barré Syndrome in the HIV-Infected Population.Journal of clinical medicine · 2023Article
- A More Comprehensive Clinical and Laboratory Characterization of 61 Acute HIV Infection Patients in Southwest China.Pathogens (Basel, Switzerland) · 2023Article
- Exposure to common infections may shape basal immunity and potentially HIV-1 acquisition amongst a high-risk population in Coastal Kenya.Frontiers in immunology · 2023Article
- Clinical Characteristics of Retroviral Rebound Syndrome: A Case Report and Literature Review.Internal medicine (Tokyo, Japan) · 2023Review
- Longitudinal patterns of inflammatory mediators after acute HIV infection correlate to intact and total reservoir.Frontiers in immunology · 2023Article
Corrections and comments
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Authors and funding
24 authors at 11 institutions in 4 countries.
Funding
Abstract
Background: Many individuals with acute human immunodeficiency virus infection (AHI) experience acute retroviral syndrome (ARS), which is associated with adverse long-term clinical outcomes. Methods: Participants presenting for voluntary human immunodeficiency virus (HIV) testing were enrolled during AHI in Bangkok, Thailand. ARS was defined by ≥3 qualifying signs/symptoms. HIV burden, immunophenotypes, and biomarkers were stratified by ARS diagnosis at enrollment and after up to 96 weeks of antiretroviral therapy (ART). Results: From 212382 samples screened, 430 participants were enrolled during AHI, including 335 (78%) with ARS. Median age was 26 years and 416 (97%) were men. Sixty (14%) underwent sigmoid biopsy and 105 (24%) underwent lumbar puncture during AHI. Common symptoms included fever (93%), fatigue (79%), pharyngitis (67%), and headache (64%). Compared to those without ARS, participants with ARS were in later Fiebig stages with higher HIV RNA in blood, colon, and cerebrospinal fluid; higher total HIV DNA in blood; CD4 depletion in blood and colon; and elevated plasma tumor necrosis factor alpha (TNF-α), C-reactive protein, and D-dimer (all P < .05). Subgroup analyses of Fiebig I/II participants (95 with ARS, 69 without) demonstrated similar findings. After 96 weeks of ART, TNF-α and interleukin 6 were elevated in the ARS group (P < .05) but other biomarkers equilibrated. Conclusions: ARS was associated with high viral burden, CD4 depletion, and immune activation across multiple body compartments during AHI and prior to ART. Persistent inflammation despite suppressive ART could contribute to increased morbidity in individuals who experience ARS.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.