US and Kenyan researchers have demonstrated a clear relationship between the severity of symptoms experienced during primary HIV infection and the amount of virus found in the blood at this time.
The study, conducted among women at high risk of HIV infection in Mombasa, Kenya, showed that women with five or more symptoms of primary infection had an average viral load that was 18,000-fold higher than women who experienced no symptoms.
The study identified 74 women who seroconverted and for whom viral load measurements were available. Women were tested for HIV on a regular basis after being recruited to the cohort study, which enrolled a total of 1295 women.
Fever, vomiting, headache, fatigue, arthralgia, myalgia, sore throat, skin rash and being too sick to work were associated with a significantly higher viral load. Asymptomatic women had a median viral load of 216 copies/ml (a level that would be regarded as a potential false positive result in at-risk individuals seen in everyday clinical practice). In women with one symptom, the median viral load was 32,111 copies/ml, compared with approximately 4 million copies/ml in women with five or more symptoms.
Lavreys L et al. Virus load during primary human immunodeficiency virus (HIV) type 1 infection is related to the severity of acute HIV illness in Kenyan women. Clinical Infectious Diseases 35 (online edition), 2002.