Fever among outpatients with advanced human immunodeficiency virus infection

Arch Intern Med. 1993 Aug 23;153(16):1909-12.

Abstract

Background: Fever is common among persons with human immunodeficiency virus (HIV) infection. However, the clinical implications of fever in this population have not been evaluated. We therefore undertook a prospective study of fever in persons with advanced HIV infection to determine the incidence and etiology of fever in this patient group.

Methods: Prospective natural history study of 176 patients with advanced HIV infection followed up at Memorial Sloan-Kettering Cancer Center, New York, NY, from April 1, 1990, through December 31, 1990.

Results: Fever occurred in 46% of patients. A diagnosis was made in 83% of episodes, with acquired immunodeficiency virus-defining illnesses accounting for half of the diagnosed cases. Patients whose conditions required more than 2 weeks to diagnose most often had lymphoma, Mycobacterium avium-intracellulare bacteremia, or Pneumocystis carinii pneumonia. Four patients had persistent unexplained fever without a clear source. Only one patient had fever that clearly responded to antiretroviral therapy.

Conclusions: Fever is common among outpatients with advanced HIV infection. Human immunodeficiency virus itself is rarely the cause of fever in such patients; the cause of the fever should be thoroughly evaluated.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • AIDS-Related Opportunistic Infections / complications
  • AIDS-Related Opportunistic Infections / diagnosis
  • Acquired Immunodeficiency Syndrome / complications*
  • Adult
  • Bacteremia / complications
  • Bacteremia / diagnosis
  • Cohort Studies
  • Female
  • Fever / diagnosis
  • Fever / etiology*
  • HIV Infections / complications*
  • Humans
  • Incidence
  • Lymphoma / complications
  • Lymphoma / diagnosis
  • Male
  • Middle Aged
  • Mycobacterium avium-intracellulare Infection / complications
  • Mycobacterium avium-intracellulare Infection / diagnosis
  • Outpatients
  • Pneumonia, Pneumocystis / complications
  • Pneumonia, Pneumocystis / diagnosis
  • Prospective Studies