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. 2011 Aug 10:14:40.
doi: 10.1186/1758-2652-14-40.

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

M Eugenia Socías  1 , 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
Collaborators, Affiliations

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

M Eugenia Socías et al. J Int AIDS Soc. .

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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Figures

Figure 1
Figure 1
Time to progression of HIV disease among untreated patients from the Grupo Argentino de Seroconversión. Progression-free survival from onset of HIV infection among untreated patients with or without symptomatic primary HIV infection.
See this image and copyright information in PMC

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