Jm. Kilby et al., Recurrence of the acute HIV syndrome after interruption of antiretroviral therapy in a patient with chronic HIV infection: A case report, ANN INT MED, 133(6), 2000, pp. 435-438
Citations number
14
Categorie Soggetti
General & Internal Medicine","Medical Research General Topics
Background: Clinical and virologic consequences of temporary interruption o
f HIV therapy are incompletely understood.
Objective: To describe a febrile illness that was consistent with the acute
HIV syndrome and occurred after interruption of antiretroviral therapy.
Design: Case report.
Setting: University clinic.
Patient: HIV-infected man.
Measurements: Plasma viral load, lymphocyte subsets, diagnostic evaluation
(including cultures and serologic tests), and analysis of lymph node tissue
.
Results: The patient began antiretroviral therapy 3 months after initial HI
V exposure and had sustained viral suppression, except during a brief sched
uled treatment interruption. One hundred sixty-nine days after resuming the
rapy, the patient discontinued it again immediately following an influenza
vaccination. Eleven days later, he presented with a febrile mononucleosis-l
ike syndrome associated with dramatic shifts in plasma HIV RNA level (<50 t
o >1 000 000 copies/mU and CD4 cell count (0.743 x 10(9) cells/L to 0.086 x
10(9) cells/L). Evaluation for alternative causes of fever was unrevealing
. Symptoms resolved rapidly with resumption of HIV therapy.
Conclusion: Therapeutic interruption may be associated with profound viral
rebound and recurrence of the acute HIV syndrome.