Weight loss associated with HIV seroconversion among injection-drug users

Area of Science:

• Infectious Diseases
• Public Health
• Epidemiology

Background:

• Primary human immunodeficiency virus (HIV) infection, or seroconversion, can present with a range of symptoms.
• Injection-drug users (IDUs) are a key population for HIV prevention and surveillance efforts.
• Understanding early symptoms of HIV seroconversion is crucial for timely diagnosis and treatment.

Purpose of the Study:

• To identify and describe symptoms associated with primary HIV infection in a cohort of IDUs.
• To determine risk factors for HIV seroconversion among IDUs.
• To compare symptom histories between individuals who seroconverted and those who did not.

Main Methods:

• A cohort of 366 IDUs was studied using a structured questionnaire for symptom recall every 3 months.
• HIV seroconversions were monitored, and Cox regression analysis was used to identify risk factors.
• An embedded case-control analysis compared symptom histories of seroconverters with matched seronegative controls.

Main Results:

• Eleven HIV seroconversions occurred at a rate of 1.8 per 100 person years at risk (PYAR).
• Age 35 years or younger was a significant risk factor for HIV seroconversion.
• Significant associations were found between HIV seroconversion and weight loss (>4.5 kg) and oral ulcers in the 3 months preceding seroconversion.

Conclusions:

• Symptom histories differ between IDUs experiencing HIV seroconversion and those who remain seronegative.
• Significant weight loss is a particularly common symptom among IDUs during primary HIV infection.
• Early identification of these symptoms can aid in the diagnosis of acute HIV infection in IDUs.