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Severe primary HIV-1 infection among black persons in Barbados

C P Hudson1, P N Levett, C N Edwards

  • 1Department of Medicine, University of the West Indies, Queen Elizabeth Hospital, Barbados.

International Journal of STD & AIDS
|June 1, 1997
PubMed

Insights

This study identified primary HIV-1 infection in a Black population in Barbados, noting clinical features distinct from leptospirosis. Findings suggest severe cases may be rare and potentially misdiagnosed.

Area of Science:

  • Infectious Diseases
  • Virology
  • Epidemiology

Background:

  • Primary HIV-1 infection descriptions often lack diversity, primarily focusing on Caucasian populations in industrialized nations.
  • Leptospirosis studies in Barbados provided access to stored serum from patients with acute febrile illnesses.
  • The Queen Elizabeth Hospital (QEH) in Barbados served as the study site.

Purpose of the Study:

  • To describe clinical features of primary Human Immunodeficiency Virus type 1 (HIV-1) infection in a predominantly Black population.
  • To investigate potential misdiagnosis of primary HIV-1 infection in patients presenting with acute febrile illnesses.
  • To assess the occurrence and characteristics of severe primary HIV-1 infection in a non-Western setting.

Main Methods:

  • Retrospective review of medical records of 510 adult patients with known HIV-1 infection at QEH.
  • Identification of 10 patients with stored serum from an acute febrile illness preceding or coinciding with their first HIV-1 positive test.
  • Serological testing to confirm primary HIV-1 infection and differentiate from leptospirosis.

Main Results:

  • Primary HIV-1 infection was confirmed in 9 out of 10 patients, with the 10th being suggestive.
  • Clinical features of primary HIV-1 infection were consistent with previous reports but differed from local leptospirosis cases.
  • Two patients experienced severe outcomes: one died during seroconversion illness, another 3 months post-seroconversion.

Conclusions:

  • Severe primary HIV-1 infection may be relatively uncommon.
  • Primary HIV-1 infection can be misdiagnosed, particularly in settings where other febrile illnesses are prevalent.
  • The occurrence of severe primary HIV-1 infection might be linked to the establishment phase of the AIDS epidemic.

Keywords:
Acquired Immunodeficiency SyndromeAmericasBarbadosBlacksCaribbeanCultural BackgroundDemographic FactorsDeveloping CountriesDiseasesEthnic GroupsHiv InfectionsNorth AmericaPopulationPopulation CharacteristicsResearch ReportSigns And SymptomsViral Diseases

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