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Rapid HIV Progression During Acute HIV-1 Subtype C Infection in a Mozambican Patient with Atypical Seroconversion

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  • ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain; Department of Preventive Medicine and Epidemiology, Hospital Clinic, Barcelona, Spain; School of Paediatrics and Child Health, University of Western Australia, Perth, Australia; IrsiCaixa Institute for AIDS Research, Institut Germans Trias i Pujol (IGTP), Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, UAB, Badalona, Spain; Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique; Instituto Nacional de Saúde, Ministério de Saúde, Maputo, Mozambique; Universitat de Vic- Universitat Central de Catalunya, Vic, Spain

Acute human immunodeficiency virus (HIV) infection (AHI) refers to the period between viral transmission and development of an adaptive immune response to HIV antigens (seroconversion) usually lasting 6–8 weeks. Rare cases have been described in which HIV-infected patients fail to seroconvert and instead, develop rapid HIV-mediated clinical decline. We report the case of a Mozambican woman with AHI and malaria coinfection who showed atypical seroconversion and experienced rapid deterioration and death within 14 weeks of diagnosis with AHI. Atypical seroconversion may be associated with rapid progression. Fourth generation rapid tests could lead to earlier identification and intervention for this vulnerable subgroup.

Author Notes

* Address correspondence to Denise Naniche, ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic - Universitat de Barcelona, Rosselló 132, 08036 Barcelona, Spain. E-mail: dsuzanne@clinic.ub.es† These authors contributed equally.

Financial support: The ongoing acute HIV study is supported by Spanish Ministry of Science (Mineco) Grant SAF-2011-27901 and Bill and Melinda Gates Foundation Grant 02398001183. L.P. is supported by Fondo de Investigación Sanitaria at the Instituto Carlos III Grant PFIS FI12/00096.

Authors' addresses: Cesar Velasco, ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain and Department of Preventive Medicine and Epidemiology, Hospital Clinic, Barcelona, Spain, E-mail: velascomunoz@gmail.com. Erica Parker, School of Paediatrics and Child Health, University of Western Australia, Perth, Australia, E-mail: ericaparker01@gmail.com. Lucia Pastor, ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain; IrsiCaixa Institute for AIDS Research, Institut Germans Trias i Pujol (IGTP), Hospital Germans Trias i Pujol, UAB, Badalona, Spain, and Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique, E-mail: Lucia.Pastor@manhica.net. Abel Nhama and Inácio Mandomando, Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique, and Instituto Nacional de Saúde, Ministério de Saúde, Maputo, Mozambique, E-mails: Abel.Nhama@manhica.net and inacio.mandomando@manhica.net. Salesio Macuacua, Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique, E-mail: Salesio.Macuacua@manhica.net. Julià Blanco, IrsiCaixa Institute for AIDS Research, Institut Germans Trias i Pujol (IGTP), Hospital Germans Trias i Pujol, UAB, Badalona, Spain, and Universitat de Vic, UVIC-UCC, Vic, Spain, E-mail: JBlanco@irsicaixa.es. Denise Naniche, ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic - Universitat de Barcelona, E-mail: dsuzanne@clinic.ub.es.

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