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Acute HIV infection presenting as hemophagocytic syndrome with an unusual serological and virological response to ART

BACKGROUND: HIV clinical presentation in the acute stage is variable and some of its virological and immunological aspects are not completely understood. Most cases of HIV- associated reactive hemophagocytic syndrome have been reported in patients with advanced stages of HIV and to our knowledge, th...

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Autores principales: Ferraz, Rita Veiga, Carvalho, Ana Cláudia, Araújo, Fernando, Koch, Carmo, Abreu, Cândida, Sarmento, António
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5086040/
https://www.ncbi.nlm.nih.gov/pubmed/27793107
http://dx.doi.org/10.1186/s12879-016-1945-9
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author Ferraz, Rita Veiga
Carvalho, Ana Cláudia
Araújo, Fernando
Koch, Carmo
Abreu, Cândida
Sarmento, António
author_facet Ferraz, Rita Veiga
Carvalho, Ana Cláudia
Araújo, Fernando
Koch, Carmo
Abreu, Cândida
Sarmento, António
author_sort Ferraz, Rita Veiga
collection PubMed
description BACKGROUND: HIV clinical presentation in the acute stage is variable and some of its virological and immunological aspects are not completely understood. Most cases of HIV- associated reactive hemophagocytic syndrome have been reported in patients with advanced stages of HIV and to our knowledge, there are only 8 cases in the English literature presenting during acute HIV infection, most in East Asia, being this the first case in a European patient. CASE PRESENTATION: We report a case of a European Caucasian 27- year old woman with a primary HIV- infection presenting with extremely low CD4+ T cell count who developed a haemophagocytic syndrome after starting ART and in whom we documented a very unusual serological and virological response, characterized by an impaired HIV- antibody production and a 12 month time frame to reach an undetectable viral load, despite no evidence of resistance. CONCLUSIONS: This case report apart from describing an unusual clinical presentation of an acute HIV infection as hemophagocytic syndrome provides useful information that might contribute for understanding some subtle issues in acute HIV infection, namely the dynamics of virological and immunological aspects after antiretroviral therapy initiation. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12879-016-1945-9) contains supplementary material, which is available to authorized users.
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spelling pubmed-50860402016-10-31 Acute HIV infection presenting as hemophagocytic syndrome with an unusual serological and virological response to ART Ferraz, Rita Veiga Carvalho, Ana Cláudia Araújo, Fernando Koch, Carmo Abreu, Cândida Sarmento, António BMC Infect Dis Case Report BACKGROUND: HIV clinical presentation in the acute stage is variable and some of its virological and immunological aspects are not completely understood. Most cases of HIV- associated reactive hemophagocytic syndrome have been reported in patients with advanced stages of HIV and to our knowledge, there are only 8 cases in the English literature presenting during acute HIV infection, most in East Asia, being this the first case in a European patient. CASE PRESENTATION: We report a case of a European Caucasian 27- year old woman with a primary HIV- infection presenting with extremely low CD4+ T cell count who developed a haemophagocytic syndrome after starting ART and in whom we documented a very unusual serological and virological response, characterized by an impaired HIV- antibody production and a 12 month time frame to reach an undetectable viral load, despite no evidence of resistance. CONCLUSIONS: This case report apart from describing an unusual clinical presentation of an acute HIV infection as hemophagocytic syndrome provides useful information that might contribute for understanding some subtle issues in acute HIV infection, namely the dynamics of virological and immunological aspects after antiretroviral therapy initiation. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12879-016-1945-9) contains supplementary material, which is available to authorized users. BioMed Central 2016-10-28 /pmc/articles/PMC5086040/ /pubmed/27793107 http://dx.doi.org/10.1186/s12879-016-1945-9 Text en © The Author(s). 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Case Report
Ferraz, Rita Veiga
Carvalho, Ana Cláudia
Araújo, Fernando
Koch, Carmo
Abreu, Cândida
Sarmento, António
Acute HIV infection presenting as hemophagocytic syndrome with an unusual serological and virological response to ART
title Acute HIV infection presenting as hemophagocytic syndrome with an unusual serological and virological response to ART
title_full Acute HIV infection presenting as hemophagocytic syndrome with an unusual serological and virological response to ART
title_fullStr Acute HIV infection presenting as hemophagocytic syndrome with an unusual serological and virological response to ART
title_full_unstemmed Acute HIV infection presenting as hemophagocytic syndrome with an unusual serological and virological response to ART
title_short Acute HIV infection presenting as hemophagocytic syndrome with an unusual serological and virological response to ART
title_sort acute hiv infection presenting as hemophagocytic syndrome with an unusual serological and virological response to art
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5086040/
https://www.ncbi.nlm.nih.gov/pubmed/27793107
http://dx.doi.org/10.1186/s12879-016-1945-9
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