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Research ArticleOriginal Research

Prevalence of Primary HIV Infection in Symptomatic Ambulatory Patients

Andrew Coco and Emily Kleinhans
The Annals of Family Medicine September 2005, 3 (5) 400-404; DOI: https://doi.org/10.1370/afm.376
Andrew Coco
MD, MS
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Emily Kleinhans
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Tables

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    Table 1.

    Primary HIV Infection Symptoms

    Symptom Reported in the LiteratureNAMCS/NHAMCS Equivalent Reason(s) for Visit
    Note: Symptoms reported by more than 25% of patients in Schacker et al,2 Hecht et al,4 and Daar et al.5
    HIV = human immunodeficiency virus; NAMCS = National Ambulatory Medical Care Survey; NHAMCS = National Hospital Ambulatory Medical Care Survey.
    1. FeverFever, chills, feeling hot
    2. PharyngitisThroat soreness, throat pain, tonsillitis
    3. LymphadenitisSore glands, swollen or enlarged glands
    4. MyalgiaUnspecified muscle pain, ache, soreness, discomfort
    5. AthralgiaUnspecified joint pain, ache, soreness, discomfort
    6. FatigueTiredness, fatigue
    7. Night sweatsExcessive sweating
    8. NauseaNausea
    9. VomitingVomiting
    10. DiarrheaDiarrhea
    11. RashSkin rash
    12. Weight lossWeight loss
    13. Oral ulcerMouth ulcer
    14. HeadacheHeadache, pain in head
    15. Neck stiffnessLimitation of movement, neck stiffness
    16. Loss of appetiteDecreased appetite
    17. MalaiseGeneral ill feeling
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    Table 2.

    Primary Human Immunodeficiency Virus Infection Estimates

    SymptomNumerator Estimate (95% CI)Denominator Estimate (95% CI)Prevalence Estimate (Range)
    Note: Prevalence estimates were obtained by dividing the numerator estimate by the denominator estimate. The low range estimate was obtained by dividing the low numerator estimate by the high denominator estimate, and the high range estimate by dividing the high numerator estimate by the low denominator estimate.
    CI = confidence interval.
    Fever14,394 (13,880–15,936)2,175,551 (1,723,031–2,628,071)0.66 (0.53–0.92)
    Rash7,540 (5,998–9,082)1,344,060 (966,721–1,721,399)0.56 (0.35–0.94)
    Pharyngitis8,568 (7,026–10,436)6,415,111 (5,528,853–7,301,369)0.13 (0.10–0.19)

Additional Files

  • Tables
  • Supplemental Tables

    Supplemental Table 1. Annual Number of Patients Visiting Physician�s Offices, Emergency Departments and Hospital Clinics With Fever and Other Top 3 Symptoms and Diagnoses Consistent With Primary HIV Infection; Supplemental Table 2. Annual Number of Patients Visiting Physician�s Offices, Emergency Departments, and Hospital Clinics With Rash and Other Top 3 Symptoms and Diagnoses Consistent With Primary HIV Infection; Supplemental Table 3. Annual Number of Patients Visiting Physician�s Offices, Emergency Departments, and Hospital Clinics With Pharyngitis and Other Top 3 Symptoms and Diagnoses Consistent With Primary HIV Infection; Supplemental Table 4. Numerator Estimate: Annual Number of Patients Aged 13 to 54 Years With Primary HIV Infection Visiting Physician Offices, Emergency Departments, and Hospital Clinics With Fever, Rash, or Pharyngitis.

    Files in this Data Supplement:

    • Supplemental data: Tables 1-4 - PDF file; 5 pages, 141 KB
  • The Article in Brief

    Cost-Effectiveness of Expanded Testing for Primary HIV Infection

    By Andrew Coco, MD
    Background: Primary HIV infection, which has flu-like symptoms, can be difficult to diagnose. This study looked at whether widespread testing for primary HIV infection would be cost-effective.
    What this study found: In a group of 2 million hypothetical patients with fever, other viral symptoms and at least one HIV risk factor, expanded testing would identify 17,054 cases and avoid infection in 435 sexual partners. Based on a cost-effectiveness analysis, expanded testing for primary HIV infection has a high probability of being cost-effective.
    Implications
    � The findings suggests that widespread testing for primary HIV infection in patients with fever or other viral symptoms could be cost-effective.
    � The authors believe that large-scale testing would be similar to screening for diseases such as colon cancer and breast cancer in its cost-effectiveness, and could help reduce the rate of HIV in the United States.
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The Annals of Family Medicine: 3 (5)
The Annals of Family Medicine: 3 (5)
Vol. 3, Issue 5
1 Sep 2005
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Prevalence of Primary HIV Infection in Symptomatic Ambulatory Patients
Andrew Coco, Emily Kleinhans
The Annals of Family Medicine Sep 2005, 3 (5) 400-404; DOI: 10.1370/afm.376

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Prevalence of Primary HIV Infection in Symptomatic Ambulatory Patients
Andrew Coco, Emily Kleinhans
The Annals of Family Medicine Sep 2005, 3 (5) 400-404; DOI: 10.1370/afm.376
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