The full content of Annals is available to subscribers

Subscribe/Learn More  >
Original Research |

Co-infection with Human Immunodeficiency Virus-Type 1 (HIV-1) and Cytomegalovirus in Two Intravenous Drug Users

Antonio Bonetti, MD; Rainer Weber, MD; Markus W. Vogt, MD; Werner Wunderli, PhD; Walter Siegenthaler, MD; and Ruedi Lüthy, MD
[+] Article, Author, and Disclosure Information

Grant Support: Supported in part by grant 3.584-7 from the Swiss National Science Foundation, the EMDO Foundation, and a grant from the Swiss Federal Office of Public Health.

Requests for Reprints: Ruedi Lüthy, MD, Division of Infectious Diseases, University Hospital, CH-8091 Zürich, Switzerland.

Current Author Addresses: Drs. Bonetti, Weber, Vogt, Lüthy: Division of Infectious Diseases, University Hospital, CH-8091 Zürich, Switzerland.

Dr. Wunderli: Institute for Immunology and Virology, University of Zürich, CH-8091 Zürich, Switzerland.

Dr. Siegenthaler: Professor and Chairman, Department of Medicine, University Hospital, CH-8091 Zürich, Switzerland.

©1989 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1989;111(4):293-296. doi:10.7326/0003-4819-111-4-293
Text Size: A A A

A mononucleosis-like illness is frequently recognized retrospectively as the first manifestation of infection with human immunodeficiency virus-type 1 (HIV-1). This acute but transient retroviral syndrome may include symptoms such as malaise, fever, sweats, myalgia, arthralgia, maculopapular rash, diarrhea, and lymphocytic meningitis. We observed two intravenous drug users who developed a severe, febrile illness with subsequent oral thrush (one also had biopsy-proven esophageal candidiasis). Both patients had weight loss, arthralgia, myalgia, and fatigue. These symptoms occurred two weeks after needle-sharing and persisted for 7 weeks in one patient and 10 weeks in the other. Both patients had serologic evidence for both acute HIV-1 and cytomegalovirus infection. Cytomegalovirus enhances HIV-1 replication in vitro, presumably by stimulating HIV-1 gene expression. Thus, the observed syndrome suggests that this viral interaction may be clinically significant because it appears to cause severe additional morbidity, which is not typical for primary infection with HIV-1. After 6 months of follow-up, one patient is completely asymptomatic but shows markedly reduced CD4+ lymphocytes. The other patient developed persistent lymphadenopathy after the acute illness, but is feeling well 21 months after infection.





Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Submit a Comment/Letter
Submit a Comment/Letter

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.


Buy Now for $42.00

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Related Articles
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.