Injecting drug users are less likely to present with fever and rash, the two most common symptoms associated with HIV seroconversion, according to a review of five cohort studies that recruit seroconverters.
The findings, published in the November 1 edition of the Journal of Acquired Immune Deficiency Syndromes, come from a review of cohorts in Geneva, Lyon, Montreal, Seattle and Sydney, and cover 378 patients diagnosed with an acute retroviral syndrome between 1985 and 2000. Symptoms were identified by standardised questionnaire.
Fever (50% vs 69%, p=0.04) and skin rash (21% vs 50%, p=0.002) were less frequent in those exposed to HIV through injecting drug use compared with those exposed through sexual intercourse. Genital ulceration was not reported amongst injecting drug users, but was seen in 4.6% of gay men and 14% of heterosexuals. Headache, pharyngitis and myalgia (muscle aches) were also less common in injecting drug users. No difference in symptoms was seen according to age or gender.
The authors suggested that the severity or recognition of symptoms in injecting drug users could be masked by the repeated use of opiates.
References
Vanhems P et al. Clinical features of acute retroviral syndrome differ by route of infection but not by gender or age. JAIDS 31: 318-321, 2002.