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Immediate immunosuppression caused by acute HIV-1 infection: A fulminant multisystemic disease 2 days post infection

Akute HIV-1-Infektion mit sofortiger Entwicklung einer Immunsuppression: Fulminante Multi-System-Erkrankung 2 Tage nach Infektion


A healthy 19-year-old woman had vaginal intercourse on a single occasion with an HIV-1 positive male from Gambia. Two days later she developed an acute HIV infection presenting as a fulminant multisystem disease that lasted for 35 hospital days and included: immediate immunosuppression with extreme CD4+ lymphocytopenia and combined with CD8+ lymphocytosis, neutropenia and hypogammaglobulinemia; intermittent spiking fever; pneumonitis; hepatitis; changing skin rashes; peripheral neuropathy with myopathy, and panencephalitis. P24 antigen was detected by Western blot on day 23 and seroconversion was detected by ELISA on day 25. Cultured lymphocytes from peripheral blood and cerebrospinal fluid grew HIV-1.


Eine gesunde 19-jährige Frau hatte einmaligen vaginalen Geschlechtsverkehr mit einem HIV-1-positiven Mann aus Gambia. Nach 2 Tagen entwickelte sich eine fulminante Multi-System-Erkrankung, die während des 35tägigen Krankenhausaufenthaltes bestehen blieb: sofortiges Auftreten einer Immunsuppression mit extremer CD4+-Lymphopenie, kombiniert mit CD8+-Lymphozytose, Neutropenie und Hypogammaglobulinämie, intermittierenden Fieberschüben, Pneumonitis, Hepatitis, wechselnden Exanthemen, peripherer Neuropathie und Myopathie sowie Panencephalitis. Der Western Blot für p24-Antigen war am Tag 23 positiv, die Serokonversion wurde am Tag 25 mit einem ELISA nachgewiesen. In Lymphozytenkulturen aus dem peripheren Blut und Liquor konnte HIV-1 angezüchtet werden.

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  1. 1.

    Kinloch-de Loes, S., De Saussure, P., Saurat, J. H., Stalder, H., Hirschel, B., Perrin, L. H. Symptomatic primary infection due to human immunodeficiency virus type 1: review of 31 cases. Clin. Infec. Dis. 17 (1993) 59–65.

    Google Scholar 

  2. 2.

    Cooper, D. A., Gold, J., Maclean, P., Donovan, B., Finlayson, R., Barnes, T. G., Michelmore, F. M., Brook, P., Penny, R. Acute AIDS retrovirus infection: definition of a clinical illness associated with seroconversion. Lancet i (1985) 537–540.

    Google Scholar 

  3. 3.

    Tindall, B., Barker, S., Donovan, B., Barnes, T., Roberts, J., Kronenberg, C., Gold, J., Penny, R., Cooper, D. Characterization of the acute clinical illness associated with human immunodeficiency virus infection. Arch. Intern. Med. 148 (1988) 945–949.

    Google Scholar 

  4. 4.

    Boyko, W. J., Schlechter, M. T., Craib, K. J. P., Willoughby, B., Douglas, B., Sestak, P., McLeod, W. A., O'Shaughnessey, M. The Vancouver lymphadenopathy-AIDS study: 7. Clinical and laboratory features of 87 cases of primary HIV infection. Can. Med. Assoc. J. 137 (1987) 109–113.

    Google Scholar 

  5. 5.

    Tindall, B., Hing, M., Edwards, P., Barnes, T., Mackie, A., Cooper, D. A. Severe clinical manifestations of primary HIV infection. AIDS 3 (1989) 747–749.

    Google Scholar 

  6. 6.

    Vonsover, A., Gotlieb-Stematsky, T., Alexander, R., Fogel, A., Rubinstein, E., Handzel, Z. T., Burstein, R., Bentwich, Z. Isolation of HIV from Israeli patients and asymptomatic carriers. Isr. J. Med. Sci. 24 (1988) 141–144.

    Google Scholar 

  7. 7.

    Skiest, D. J., King, M. E. Granulocytopenia secondary to acute infection with the human immunodeficiency virus. J. Infect. 28 (1994) 315–318.

    Google Scholar 

  8. 8.

    Pantaleo, G., Graziosi, C., Fauci, A. S. The immunopathogenesis of human immunodeficiency virus infection. N. Engl. J. Med. 328 (1993) 327–335.

    Google Scholar 

  9. 9.

    Sinicco, A., Fora, R., Sciandra, M., Lucchini, A., Caramello, P., Gioahnini, P. Risk of developing AIDS after primary acute HIV-1 infection. AIDS 6 (1993) 575–581.

    Google Scholar 

  10. 10.

    Keet, I. P. M., Krijnen, P., Koot, M., Lange, J. M., Miedema, F., Goudsmit, J., Coutinho, R. A. Predictors of rapid progression to AIDS in HIV-1 seroconverters. AIDS 7 (1993) 51–57.

    Google Scholar 

  11. 11.

    Miralles, P., Moreno, S., Perez-Tascon, M., Cosin, J., Diaz, M. D., Bouza, E. Fever of uncertain origin in patients infected with the human immunodeficiency virus. Clin. Infect. Dis. 20 (1995) 872–875.

    Google Scholar 

  12. 12.

    Tindall, B., Carr, A., Goldstein, D., Penny, R., Cooper, D. A. Administration of zidovudine during primary HIV-1 infection may be associated with a less vigorous immune response. AIDS 7 (1993) 127–144.

    Google Scholar 

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Correspondence to M. Garty M. D..

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Ben-Galim, P., Shaked, Y., Garty, M. et al. Immediate immunosuppression caused by acute HIV-1 infection: A fulminant multisystemic disease 2 days post infection. Infection 24, 332–335 (1996).

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  • Hepatitis
  • Western Blot
  • Neuropathy
  • Neutropenia
  • General Practice