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Acute HIV seroconversion illness presenting as African viral haemorrhagic fever
D J Martin1, S F Lyons, J G Sim
1MRC AIDS Virus Research Unit, National Institute for Virology and Department of Virology, University of Witwatersrand, Johannesburg, South Africa.
Background:
Both human immunodeficiency virus type 1 (HIV-1) and African viral haemorrhagic fever (VHF) viruses cause similar symptoms in acutely infected individuals and must be included in the differential diagnosis in areas where HIV-1 and VHF viruses both occur.
Objectives:
To determine the cause of an acute illness in a patient at risk of exposure to both HIV-1 and African VHF viruses.
Results:
Serological examination revealed the presence of high levels of the p24 core antigen of HIV-1 in the absence of antibodies to HIV-1 in a specimen collected during the acute stage of the infection. On follow-up, the antigen enzyme-linked immunosorbent assay (ELISA) became negative while the antibody ELISA and confirmatory Western blot for HIV-1 became positive.
Conclusions:
Acute HIV seroconversion illness may have protean manifestations and, in the more severe forms, may cause diagnostic dilemmas, particularly in regions where African VHFs occur.