Acute HIV infection in a large teaching hospital in western China: Clinical, virological, and molecular epidemiological characteristics

Abstract

Objective To provide information on clinical, virological, and molecular epidemiological characteristics for early identification, diagnosis, and treatment of acute HIV infection (AHI). Methods A retrospective study was conducted with patients with AHI from 2012 to 2017 in West China Hospital. Results A total of 47 patients with AHI were found using a fourth‐generation kit. Thirteen (27.66%) of these patients were negative if tested by third‐generation tests. Median age of patients with AHI was 26 and 91.49% of them were males. Homosexual contact was responsible for 46.81% of AHI transmission. Among the individuals with AHI, 80.85% were outpatients. Common symptoms/signs were fever, headache, rash, cough and sputum, and sore throat. The syphilis coinfection rate was 17.24%. Most of the AHI was distributed in Fiebig stages IV (61.70%) and II (27.66%) with different clinical and virological characteristics. The increasing trend of cut‐off index values was obvious in the course of AHI, helpful for auxiliary diagnosis. The main genetic forms of AHI were CRF07_BC and CRF01_AE, and a rare subtype CRF55_01B in Sichuan province was found. The drug resistance mutation rate was relatively high (17.65%) and five different mutations were identified. Conclusions Fourth‐generation assays are strongly recommended for screening AHI compared to third‐generation ones. Different clinical and virological characteristics in different Fiebig stages were found. Young individuals and outpatients were the majority of patients with AHI and this deserves special attention. Attention should also be paid to the rare CRF55_01B in Sichuan province and surveillance of HIV resistance ought to be strengthened.

Low rate of pre-exposure prophylaxis and post-exposure prophylaxis uptake and high prevalence of transmitted drug resistance among newly diagnosed primary HIV infections in Shenzhen, China: a real-world retrospective study

“…TDR is another determinant that may impact the achievement of the last 95% target. Intriguingly, extremely high rates of TDR were found in this study, which were substantially higher than those in previous reports [5,37] . Previous studies showed a wide range (2.0%–15.0%) [38,39] of prevalence of TDR in China and significantly higher levels in developed countries (8.3%–17.2%), [40–44] which differs according to the study population, time interval, and definition of TDR.…”

“…Intriguingly, extremely high rates of TDR were found in this study, which were substantially higher than those in previous reports. [ 5 , 37 ] Previous studies showed a wide range (2.0%–15.0%) [ 38 , 39 ] of prevalence of TDR in China and significantly higher levels in developed countries (8.3%–17.2%), [ 40 – 44 ] which differs according to the study population, time interval, and definition of TDR. The high prevalence of drug resistance against NNRTI would pose a great threat to NNRTI-containing regimens in resource-limited regions in future.…”