ACUTE HUMAN-IMMUNODEFICIENCY-VIRUS TYPE-1 DISEASE AS A MONONUCLEOSIS-LIKE ILLNESS - IS THE DIAGNOSIS TOO RESTRICTIVE

The purpose of this study was to describe the frequency and duration o f clinical features at the time of acute human immunodeficiency virus type 1 (HIV-I) disease in 218 patients with documented symptomatic pri mary HIV-1 infection, The mean duration of acute HIV-1 disease was 25. 1 days (median, 20.0 days) and did not differ by gender, age, and risk factor, The frequency and mean duration of clinical features occurrin g in >50% of patients were as follows: fever, 77.1% and 16.9 days; let hargy, 65.6% and 23.7 days; cutaneous rash, 56.4% and 15 days; myalgia , 54.6% and 17.7 days; and headache, 50.9% and 25.8 days, Only 15.6% o f patients presented with a typical mononucleosis-like illness (MLI) d efined as fever, pharyngitis or sore throat, and cervical adenopathy, and 10% had no features of an MLI, A meningitis-like syndrome occurred in 20 patients (9.2%). Acute HIV-1 disease is more diverse than previ ously reported, and the absence of fever or other MLI features does no t rule out acute HIV-1 disease.