Comparative analysis of clinical manifestations of the acute stage of HIV infection of patients detected between 2008–2013 and 2018–2022 in Saint Petersburg

Aim of the study. Comparative analysis of clinical manifestations and laboratory indicators of acute HIV infection in patients detected in different epidemic periods with a 10-year difference (2008–2013 and 2018–2022).

Materials and methods. An analysis of 142 inpatient records of patients detected in the acute stage of HIV infection in the period from 2008–2013 in the ‘Botkin Clinical Infectious Diseases Hospital’ (‘Botkin Hospital’) and 110 outpatient records of patients detected in the “Centre for the Prevention and Control of AIDS and Infectious Diseases” (“Centre for the Prevention and Control of AIDS and Infectious Diseases”) was conducted., in whom acute stage of HIV infection was detected from 2018– 2022 in “Botkin Hospital”. We evaluated clinical and laboratory results of patients in different years of infection.

Results and discussion. Over the ten years of the HIV epidemic in the city of St. Petersburg, new trends in the clinical picture of the acute stage of HIV infection can be found. Over the period 2018–2022, the overall intoxication syndrome severity decreased: fever was more often febrile (72%), lasting from 3–5 days, myalgia — 20%, arthralgia — 15%, mouth mucosal aphthae were found in 7% of patients, skin rashes were observed only in 34%, and lymphadenopathy — 30%. Gastrointestinal disorders were also noted in 28%. Of the secondary and opportunistic infections, OPC prevailed in 83%, oesophageal mycosis in 17%, and serous meningitis in 17%. The median CD4-lymphocyte count was 24–573 kL/μL.

Conclusion. the data obtained show that the acute stage of HIV infection has become easier, with a decrease in the intensity and duration of the febrile period, less frequent skin manifestations, secondary diseases, and higher CD4 lymphocyte counts. As a result, diagnosis of the acute phase of HIV infection is difficult for primary care physicians. In any person presenting with signs or symptoms of a viral infection (influenza, infectious mononucleosis, rubella, enteroviruses, etc.), acute HIV infection must be included in the differential diagnosis.

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