Clinical picture of primary HIV infection presenting as a glandular-fever-like illness.

Gaines, Hans; Sydow, M von; Pehrson, P; Lundbegh, P.

doi:10.1136/bmj.297.6660.1363

Cited by 115 publications

(42 citation statements)

References 39 publications

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“…The PCR conditions included: 94°C for 2 min followed by 45 (8). The eclipse phase is defined by the interval between transmission and first detection of vRNA in the plasma and generally lasts about 10 days, with a range of approximately 7 to 21 days (3,10,(17)(18)(19)40). The mean durations of Fiebig stages I (7 days), II (5 days), III (3 days), IV (6 days), and V/VI (70ϩ days) are indicated.…”

Section: Methodsmentioning

confidence: 99%

Deciphering Human Immunodeficiency Virus Type 1 Transmission and Early Envelope Diversification by Single-Genome Amplification and Sequencing

Salazar-Gonzalez¹,

Bailes

Pham³

et al. 2008

J Virol

548

677

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Accurate identification of the transmitted virus and sequences evolving from it could be instrumental in elucidating the transmission of human immunodeficiency virus type 1 (HIV-1) and in developing vaccines, drugs, or microbicides to prevent infection. Here we describe an experimental approach to analyze HIV-1 env genes as intact genetic units amplified from plasma virion RNA by single-genome amplification (SGA), followed by direct sequencing of uncloned DNA amplicons. We show that this strategy precludes in vitro artifacts caused by Taq-induced nucleotide substitutions and template switching, provides an accurate representation of the env quasispecies in vivo, and has an overall error rate (including nucleotide misincorporation, insertion, and deletion) of less than 8 ؋ 10 ؊5 . Applying this method to the analysis of virus in plasma from 12 Zambian subjects from whom samples were obtained within 3 months of seroconversion, we show that transmitted or early founder viruses can be identified and that molecular pathways and rates of early env diversification can be defined. Specifically, we show that 8 of the 12 subjects were each infected by a single virus, while 4 others acquired more than one virus; that the rate of virus evolution in one subject during an 80-day period spanning seroconversion was 1.7 ؋ 10 ؊5 substitutions per site per day; and that evidence of strong immunologic selection can be seen in Env and overlapping Rev sequences based on nonrandom accumulation of nonsynonymous mutations. We also compared the results of the SGA approach with those of moreconventional bulk PCR amplification methods performed on the same patient samples and found that the latter is associated with excessive rates of Taq-induced recombination, nucleotide misincorporation, template resampling, and cloning bias. These findings indicate that HIV-1 env genes, other viral genes, and even full-length viral genomes responsible for productive clinical infection can be identified by SGA analysis of plasma virus sampled at intervals typical in large-scale vaccine trials and that pathways of viral diversification and immune escape can be determined accurately.

show abstract

Section: Methodsmentioning

confidence: 99%

Deciphering Human Immunodeficiency Virus Type 1 Transmission and Early Envelope Diversification by Single-Genome Amplification and Sequencing

Salazar-Gonzalez¹,

Bailes

Pham³

et al. 2008

J Virol

548

677

View full text Add to dashboard Cite

show abstract

“…Since then, a number of case reports and reports of small series have shown an ever-evolving spectrum of clinical manifestations such as mucocutaneous lesions, odynophagia, lymphadenopathy, splenomegaly, nausea, vomiting, diarrhea, arthralgia, myalgia, headache, retroorbital pain, and neurological syndromes. The latter include serious conditions such as vasculitis, aplastic anemia, esophageal candidiasis, hepatitis, spontaneous rupture of the spleen, pneumonitis with respiratory failure, renal involvement, and rhabdomyolysis [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18].…”

mentioning

confidence: 99%

Symptomatic Primary Infection Due to Human Immunodeficiency Virus Type 1: Review of 31 Cases

Loés

Saussure

Saurat

et al. 1993

Clinical Infectious Diseases

142

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In this series of 31 patients with acute infection due to human immunodeficiency virus (HIV) type 1, the male-to-female ratio was 3.4:1 and the mean age was 31.3 years. Sexual transmission accounted for 83.9% of cases; 45.2% of the patients were homosexual and 38.7% were heterosexual. The mean duration of symptoms and signs was 21 days (range, 5-60 days). Fever (87.1%) and skin rash (67.7%) were most commonly reported. Physical examination findings were abnormal for 96% of the patients; the oral cavity (76.7%) and the skin (73.3%) were the most frequently involved sites. Thirteen of 25 patients with sexually acquired infection had genital or oral ulcers, whereas five intravenous drug users had none (P = .052). Thrombocytopenia was the most common hematologic abnormality and was detected in 17 of 23 patients tested. P24 antigenemia, an initially negative screening test for HIV antibody, and a low CD4+ lymphocyte count were noted in 23 of 29, 23 of 30, and 14 of 21 tested patients, respectively.

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“…We therefore refer to sampled peaks as observed maxima (see Methods and Materials in the supplemental material). We estimate that the mean time from HIV-1 transmission to appearance of plasma virus is approximately 10 days (14,16,18,24,25,46,59). Thus, for plasma donors the maximal VL occurred a mean of 23.9 days after transmission.…”

Section: Vol 82 2008 Cell Death During Early Hiv-1 Infection 7703mentioning

confidence: 94%

“…In investigations of human subjects, Guadalupe et al (26), Brenchley et al (9), and Mehandru and colleagues (51) studied 2, 1, and 9 patients, respectively, during the first month of HIV-1 infection and found depletion of gut CD4 ϩ T cells. The eclipse phase of HIV-1 infection (from transmission until the appearance of plasma viremia) is estimated to be 10 days in length, with a range of 7 to 21 days (14,16,18,24,25,46,59). The time from the appearance of HIV-1 viremia to the time of the first antibody response and symptomatic HIV-1 infection (and establishment of the latent pool) is approximately 15 days (13,16,18,25).…”

mentioning

confidence: 99%

Induction of Plasma (TRAIL), TNFR-2, Fas Ligand, and Plasma Microparticles after Human Immunodeficiency Virus Type 1 (HIV-1) Transmission: Implications for HIV-1 Vaccine Design

Gasper-Smith

Crossman

Whitesides

et al. 2008

J Virol

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Clinical picture of primary HIV infection presenting as a glandular-fever-like illness.

Cited by 115 publications

References 39 publications

Deciphering Human Immunodeficiency Virus Type 1 Transmission and Early Envelope Diversification by Single-Genome Amplification and Sequencing

Deciphering Human Immunodeficiency Virus Type 1 Transmission and Early Envelope Diversification by Single-Genome Amplification and Sequencing

Symptomatic Primary Infection Due to Human Immunodeficiency Virus Type 1: Review of 31 Cases

Induction of Plasma (TRAIL), TNFR-2, Fas Ligand, and Plasma Microparticles after Human Immunodeficiency Virus Type 1 (HIV-1) Transmission: Implications for HIV-1 Vaccine Design

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