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August 23, 1993

Fever Among Outpatients With Advanced Human Immunodeficiency Virus Infection

Author Affiliations

From the Infectious Disease Service, Memorial Sloan-Kettering Cancer Center, and the New York Hospital-Cornell Medical Center, New York, NY. Dr Telzak is now with the Bronx (NY) Lebanon Medical Center.

Arch Intern Med. 1993;153(16):1909-1912. doi:10.1001/archinte.1993.00410160077006

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.(Arch Intern Med. 1993;153:1909-1912)