Descriptions of primary HIV-1 infection have so far been based on Caucasians living in industrialized nations. Due to studies of leptospirosis in the predominantly black population of Barbados, serum was available for patients admitted with acute febrile illnesses to the Queen Elizabeth Hospital (QEH). By searching the medical records of 510 adult patients with known HIV-1 infection we identified 10 patients who had stored serum from an admission for an acute febrile illness that predated or coincided with their first HIV-1-positive test. Serological testing confirmed primary HIV-1 infection in 9 and was suggestive in the 10th patient. The clinical features of these 10 patients were in keeping with previous descriptions of primary HIV-1 infection but differed from leptospirosis cases seen at the QEH. One patient died during his seroconversion illness and another died 3 months after seroconversion. The findings suggest that severe primary HIV-1 infection could be a relatively uncommon occurrence, that the condition may be misdiagnosed, and that cases may not occur until the AIDS epidemic is established. :A retrospective review was conducted of the medical records of 510 HIV-1-positive adult patients who had attended the Queen Elizabeth Hospital (QEH) to determine whether any had been admitted for an illness compatible with a diagnosis of primary HIV-1 infection. A serum bank, created from patients who had been admitted with acute febrile illnesses and investigated for leptospirosis, provided serological evidence for primary HIV-1 infection in 10 patients. Serological testing of the serum samples confirmed primary HIV-1 infection in nine patients and was suggestive in the tenth. The clinical features of the 10 patients fit the earlier descriptions of primary HIV-1 infection, but differed from the leptospirosis cases seen at the QEH. One patient died during his seroconversion illness and another died 3 months after seroconversion. These findings suggest that severe primary HIV-1 infection could be a relatively uncommon occurrence, that the condition may be misdiagnosed, and that cases may not occur until the AIDS epidemic is established.

译文

:到目前为止,主要针对HIV-1感染的描述都是基于生活在工业化国家中的高加索人。由于对巴巴多斯主要是黑人人群的钩端螺旋体病进行了研究,因此伊丽莎白女王医院(QEH)接受了急性发热性疾病的患者可获得血清。通过搜索510例已知HIV-1感染的成年患者的病历,我们确定了10例在首次发热HIV-1阳性测试之前或与其同时发生的急性发热疾病患者入院时就储存了血清的患者。血清学检查证实了9例原发性HIV-1感染,并提示第10例患者。这10例患者的临床特征与原发性HIV-1感染的先前描述相符,但与QEH所见的钩端螺旋体病病例有所不同。一名患者在血清转化疾病中死亡,另一名患者在血清转化后3个月死亡。研究结果表明,严重的原发性HIV-1感染可能是相对罕见的事件,该病可能被误诊,只有在AIDS流行之前,病例才可能发生。
:回顾性分析了510例曾在伊丽莎白女王医院(QEH)住院的HIV-1阳性成年患者的病历,以确定是否有人因与原发性HIV-1感染诊断相符的疾病而入院。由被接纳患有急性发热性疾病的患者创建的血清库,并研究了钩端螺旋体病,为10例患者的原发性HIV-1感染提供了血清学证据。血清样本的血清学检测证实了9名患者的原发性HIV-1感染,而第十名患者则具有启发性。这10例患者的临床特征符合原发性HIV-1感染的早期描述,但与QEH所见的钩端螺旋体病病例有所不同。一名患者在血清转化疾病中死亡,另一名患者在血清转化后3个月死亡。这些发现表明,严重的原发性HIV-1感染可能是相对罕见的事件,可能会误诊该病,并且直到艾滋病流行才可能发生。

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