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Fever or unknown origin in HIV/AIDS patients
1Infectious Disease Division, Winthrop-University Hospital, Mineola, New York 11501, USA.
Drugs of Today (Barcelona, Spain : 1998)
|September 16, 2003
Summary
Fevers of unknown origin (FUO) in HIV/AIDS patients are often caused by intracellular pathogens like Mycobacterium avium-intracellulare and Pneumocystis carinii pneumonia (PCP). These infections typically manifest in late-stage illness when CD4 counts are below 100.
Area of Science:
- Infectious Diseases
- Immunology
- Public Health
Background:
- Fevers of unknown origin (FUO) present a diagnostic challenge, particularly in immunocompromised populations such as patients with Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS).
- Infections are the primary cause of FUO in HIV/AIDS patients, often reflecting opportunistic pathogens common in this demographic.
- These infections manifest as prolonged fevers, indicating a significant underlying pathology.
Purpose of the Study:
- To identify the common infectious etiologies of FUO in patients with HIV/AIDS.
- To highlight the geographical variations in FUO causes, distinguishing between North American and worldwide prevalent pathogens.
- To correlate the occurrence of FUO with disease stage, specifically CD4+ T-cell counts.
Main Methods:
- Review of clinical data and etiological investigations of HIV/AIDS patients presenting with FUO.
- Analysis of common intracellular pathogens implicated in FUO within the HIV/AIDS cohort.
- Comparison of etiological profiles based on geographical location (North America vs. worldwide).
Main Results:
- In North America, disseminated Mycobacterium avium-intracellulare, Pneumocystis carinii pneumonia (PCP), fungal infections, and cytomegalovirus are leading causes of FUO in HIV/AIDS.
- Globally, Mycobacterium tuberculosis and leishmaniasis are significant contributors to FUO in this patient group.
- FUO in the HIV/AIDS population is predominantly observed in advanced stages of the disease, characterized by CD4+ T-cell counts below 100 cells/mm³.
Conclusions:
- The etiology of FUO in HIV/AIDS patients is largely driven by intracellular pathogens, mirroring common opportunistic infections but presenting as prolonged fevers.
- Geographical location significantly influences the specific pathogens responsible for FUO in HIV/AIDS patients.
- Monitoring CD4+ T-cell counts is crucial, as FUO in HIV/AIDS patients typically indicates severe immunosuppression and late-stage disease.