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Acute HIV infection presenting as hemophagocytic syndrome with an unusual serological and virological response to ART.

Acute HIV infection presenting as hemophagocytic syndrome with an unusual serological and virological response to ART.
Author Information (click to view)

Ferraz RV, Carvalho AC, Araújo F, Koch C, Abreu C, Sarmento A,


Ferraz RV, Carvalho AC, Araújo F, Koch C, Abreu C, Sarmento A, (click to view)

Ferraz RV, Carvalho AC, Araújo F, Koch C, Abreu C, Sarmento A,

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BMC infectious diseases 2016 Oct 2816(1) 619

Abstract
BACKGROUND
HIV clinical presentation in the acute stage is variable and some of its virological and immunological aspects are not completely understood. Most cases of HIV- associated reactive hemophagocytic syndrome have been reported in patients with advanced stages of HIV and to our knowledge, there are only 8 cases in the English literature presenting during acute HIV infection, most in East Asia, being this the first case in a European patient.

CASE PRESENTATION
We report a case of a European Caucasian 27- year old woman with a primary HIV- infection presenting with extremely low CD4+ T cell count who developed a haemophagocytic syndrome after starting ART and in whom we documented a very unusual serological and virological response, characterized by an impaired HIV- antibody production and a 12 month time frame to reach an undetectable viral load, despite no evidence of resistance.

CONCLUSIONS
This case report apart from describing an unusual clinical presentation of an acute HIV infection as hemophagocytic syndrome provides useful information that might contribute for understanding some subtle issues in acute HIV infection, namely the dynamics of virological and immunological aspects after antiretroviral therapy initiation.

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