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Clinical Crossroads
February 24, 1999

An Asymptomatic 41-Year-Old Man With HIV Infection

Author Affiliations

Author Affiliation: Dr Makadon is Vice President, Medical Affairs, Beth Israel Deaconess Medical Center, and Associate Professor of Medicine, Harvard Medical School, Boston, Mass.


Clinical Crossroads at Beth Israel Deaconess Medical Center is produced and edited by Thomas L. Delbanco, MD, Jennifer Daley, MD, and Richard A. Parker, MD; Erin E. Hartman, MS, is managing editor. Clinical Crossroads section editor: Margaret A. Winker, MD, Deputy Editor, JAMA.

JAMA. 1999;281(8):739-744. doi:10.1001/jama.281.8.739

DR DELBANCO: Mr K is a 41-year-old man who is clinically well but infected with the human immunodeficiency virus (HIV). An immigrant to the United States, he owns a retail business near Boston, Mass. He is covered by a commercial managed care insurance plan and, since 1994, has received care from a faculty physician in the primary care practice at the Beth Israel Deaconess Medical Center.

Mr K is gay and was in a primarily monogamous relationship since the 1980s. Mr K believes he contracted HIV infection from his partner, who had multiple partners prior to their relationship. In 1990, Mr K had a short episode of upper respiratory tract viral symptoms, with cough and fever, and subsequent test results were positive for HIV infection. His partner was tested and was also found to be HIV positive. Mr K became extremely depressed for several months and was barely able to work. His depression improved without psychiatric or pharmacological intervention and, since that time, he has focused his attention on his work and his partner's progressive and recently fatal illness.

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