Acute HIV infection with atypical clinical and laboratory presentation: case report
DOI:
https://doi.org/10.33448/rsd-v10i10.19016Keywords:
HIV; Serology; Epidemiology; Diagnosis.Abstract
Introduction: Infection with the human immunodeficiency virus (HIV) represents, in Brazil and in the world, a public health problem: estimates show that, in 2017, 42,420 new cases of HIV were diagnosed in Brazil. Despite these high rates, it is noted that underdiagnosis is still a problem: data show that, in the United States, almost 15% of people infected with the HIV virus are unaware of this diagnosis. Objective: to report an atypical case of acute HIV infection, describing its clinical and laboratory evolution until the diagnosis was confirmed, in addition to highlighting the importance of clinical suspicion in cases where the clinical picture is uncommon and the initial serological tests are not definitive for diagnosis. Methodology: this is a clinical case study with a qualitative and descriptive perspective, which consists of a research that, in general, takes place with direct data collection, in which the researcher is the indispensable instrument. Case report: female patient, 20 years old, diagnosed with HIV. It did not manifest some of the most common main signs and symptoms, such as asthenia, pharyngitis and skin rashes, evidencing, on the other hand, phenomena related to severe liver involvement, with significant laboratory hepatitis, which is not common. Conclusion: early diagnosis and implementation of antiretroviral therapy (ART) collaborate with the achievement of favorable therapeutic results: it achieves a long viral suppression, preservation and even increase of immune functions and the conservation of a more homogeneous viral population.
References
Bartlett, J. G. & Sax, P. (2016). Screening and diagnostic testing for HIV infection. UpToDate. Waltham, MA.
Berman, A., Cahn, P., Spindler, U., Lucero, E., Paz, S. & Espinoza, L. R. (1999). Human immunodeficiency virus infection associated arthritis: clinical characteristics. Journal Of Rheumatology. 26 (5), 1158-1162.
Brasil. Ministério da Saúde. Secretaria de Vigilância em Saúde. (2019). Coordenação-Geral de Desenvolvimento da Epidemiologia em Serviços. Guia de Vigilância em Saúde: volume único [recurso eletrônico] / Ministério da Saúde, Secretaria de Vigilância em Saúde, Coordenação-Geral de Desenvolvimento da Epidemiologia em Serviços. – 3ª. ed. – Brasília : Ministério da Saúde.
Chinniah, K., Mody, G. M., Bhimma, R. & Adhikari, M. (2005). Arthritis in association with human immunodeficiency virus infection in Black African children: causal or coincidental? Rheumatology, 44 (7), 915-920.
Ferreira, L; S., Conto, B. F., Narvaez, G. A. (2018). Síndromes de Mononucleose. Disponível em: <http://docs.bvsalud.org/biblioref/2018/04/882328/sindromes-de-mononucleose.pdf>.
Loreto, S. & Pereira, J. M. A. (2012). A infecção por HIV – importância das fases iniciais e do diagnóstico precoce. Acta Farmacêutica Portuguesa, Lisboa, 2 (1), 5-17.
Ministério da Saúde. (2018). Manual técnico para o diagnóstico da infecção pelo HIV em adultos e crianças. Brasília.
Portaria SAS/MS nº 1150. (2015). Protocolo Clínico e Diretrizes Terapêuticas: Artrite Reativa – Doença de Reiter. 11 de novembro de 2015.
Secretaria de Vigilância em Saúde (2018). Departamento de Vigilância, Prevenção e Controle das Infecções Sexualmente Transmissíveis, do HIV/Aids e das Hepatites Virais. Protocolo clínico e diretrizes terapêuticas para manejo da infecção pelo hiv em adultos. Brasília.
Secretaria de Vigilância em Saúde (2018). Departamento de Vigilância, Prevenção e Controle das Infecções Sexualmente Transmissíveis, do HIV/Aids e das Hepatites Virais. Protocolo clínico e diretrizes terapêuticas para manejo da infecção pelo hiv em adultos. Brasília.
Secretaria de Vigilância em Saúde (2018). Ministério da Saúde. Boletim Epidemiológico HIV/AIDS. Brasília.
Secretaria de Vigilância em Saúde Departamento de DST, Aids e Hepatites Virais. (2014). Manual Técnico para o Diagnóstico da Infecção pelo HIV. Brasília.
Ungprasert, P., Permpalung, N., Srivali, N., Bischof, E. F. & Edmonds, L. C. (2013). Pneumocystis pneumonia during primary HIV infection: a case report and review of the literature. Journal of Infection and Chemotherapy, 19 (5). 990-991.
Vilar, F. C. & Santana, R. C. (2008). Síndrome da imunodeficiência adquirida 1 (1), 1-73.
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Copyright (c) 2021 Larissa Silva Cyrino; Bárbara Queiroz de Figueiredo; Célio Honório Lopes Júnior; Isadora Caixeta Marques; Luana Silva Cyrino; Maria Fernanda Carbonaro Silva; Maria Paula Pereira Lessa; Mauro Soares Marra; Stéfani do Vale; Bruno César de Oliveira Pires
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