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A More Comprehensive Clinical and Laboratory Characterization of 61 Acute HIV Infection Patients in Southwest China
Acute HIV infection (AHI), i.e., the early stage of HIV infection, plays an important role in immune system failure and HIV transmission, but most AHI patients are missed due to their non-specific symptoms. To facilitate the identification of patients with high AHI risk and reduction of missed diagn...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9864376/ https://www.ncbi.nlm.nih.gov/pubmed/36678489 http://dx.doi.org/10.3390/pathogens12010142 |
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author | Shi, Wu Yang, Mei Wei, Yinhao Tang, Zhuoyun Luo, Lan Deng, Jielun Tao, Chuanmin |
author_facet | Shi, Wu Yang, Mei Wei, Yinhao Tang, Zhuoyun Luo, Lan Deng, Jielun Tao, Chuanmin |
author_sort | Shi, Wu |
collection | PubMed |
description | Acute HIV infection (AHI), i.e., the early stage of HIV infection, plays an important role in immune system failure and HIV transmission, but most AHI patients are missed due to their non-specific symptoms. To facilitate the identification of patients with high AHI risk and reduction of missed diagnosis, we characterized 61 AHI patients in a Southwest China hospital with 4300 beds; specifically, we characterized their general clinical characteristics, evolution in results of a novel HIV screening assay called Elecsys(®) HIV Duo, and by programming, we analyzed the ability of all routine laboratory tests (e.g., routine blood analysis) to identify AHI patients. Among 61 AHI patients, 85.2% were male and the median age was 42 (interquartile range, 25–62) years. A total of 61.9% of patients visit the emergency department first during AHI. Clinical presentation of AHI patients included fever, fatigue, chills, rash, and various respiratory, digestive, and nervous system symptoms. Two of three results from Elecsys(®) HIV Duo show clear evolution trends: HIV P24 antigen decreased while HIV antibody increased in consecutive samples of nearly all patients. High fluorescence lymphocytes have a very high positive likelihood ratio (LR+) of 10.33 and a relatively high “rate of out-of-range tests” of 56.8% (21 in 37 patients who received this test had a result outside the reference range). In addition, we identified more than ten tests with LR+ greater than two. In summary, the emergency department is important for AHI screening. The evolution of HIV P24 Ag and HIV Ab and those laboratory tests with a high “rate of out-of-range tests” or high LR+ may aid the AHI identification and missed diagnosis reduction. |
format | Online Article Text |
id | pubmed-9864376 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-98643762023-01-22 A More Comprehensive Clinical and Laboratory Characterization of 61 Acute HIV Infection Patients in Southwest China Shi, Wu Yang, Mei Wei, Yinhao Tang, Zhuoyun Luo, Lan Deng, Jielun Tao, Chuanmin Pathogens Article Acute HIV infection (AHI), i.e., the early stage of HIV infection, plays an important role in immune system failure and HIV transmission, but most AHI patients are missed due to their non-specific symptoms. To facilitate the identification of patients with high AHI risk and reduction of missed diagnosis, we characterized 61 AHI patients in a Southwest China hospital with 4300 beds; specifically, we characterized their general clinical characteristics, evolution in results of a novel HIV screening assay called Elecsys(®) HIV Duo, and by programming, we analyzed the ability of all routine laboratory tests (e.g., routine blood analysis) to identify AHI patients. Among 61 AHI patients, 85.2% were male and the median age was 42 (interquartile range, 25–62) years. A total of 61.9% of patients visit the emergency department first during AHI. Clinical presentation of AHI patients included fever, fatigue, chills, rash, and various respiratory, digestive, and nervous system symptoms. Two of three results from Elecsys(®) HIV Duo show clear evolution trends: HIV P24 antigen decreased while HIV antibody increased in consecutive samples of nearly all patients. High fluorescence lymphocytes have a very high positive likelihood ratio (LR+) of 10.33 and a relatively high “rate of out-of-range tests” of 56.8% (21 in 37 patients who received this test had a result outside the reference range). In addition, we identified more than ten tests with LR+ greater than two. In summary, the emergency department is important for AHI screening. The evolution of HIV P24 Ag and HIV Ab and those laboratory tests with a high “rate of out-of-range tests” or high LR+ may aid the AHI identification and missed diagnosis reduction. MDPI 2023-01-14 /pmc/articles/PMC9864376/ /pubmed/36678489 http://dx.doi.org/10.3390/pathogens12010142 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Shi, Wu Yang, Mei Wei, Yinhao Tang, Zhuoyun Luo, Lan Deng, Jielun Tao, Chuanmin A More Comprehensive Clinical and Laboratory Characterization of 61 Acute HIV Infection Patients in Southwest China |
title | A More Comprehensive Clinical and Laboratory Characterization of 61 Acute HIV Infection Patients in Southwest China |
title_full | A More Comprehensive Clinical and Laboratory Characterization of 61 Acute HIV Infection Patients in Southwest China |
title_fullStr | A More Comprehensive Clinical and Laboratory Characterization of 61 Acute HIV Infection Patients in Southwest China |
title_full_unstemmed | A More Comprehensive Clinical and Laboratory Characterization of 61 Acute HIV Infection Patients in Southwest China |
title_short | A More Comprehensive Clinical and Laboratory Characterization of 61 Acute HIV Infection Patients in Southwest China |
title_sort | more comprehensive clinical and laboratory characterization of 61 acute hiv infection patients in southwest china |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9864376/ https://www.ncbi.nlm.nih.gov/pubmed/36678489 http://dx.doi.org/10.3390/pathogens12010142 |
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