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JAIDS Journal of Acquired Immune Deficiency Syndromes:
doi: 10.1097/QAI.0b013e31817bebc5
Clinical Science

Fever After a Stay in the Tropics: Clinical Spectrum and Outcome in HIV-Infected Travelers and Migrants

Bottieau, Emmanuel MD, PhD*; Florence, Eric MD, PhD*; Clerinx, Jan MD*; Vlieghe, Erika MD*†; Vekemans, Marc MD*; Moerman, Filip MD*; Lynen, Lut MD*; Colebunders, Robert MD, PhD*†; Van Gompel, Alfons MD*; Van den Ende, Jef MD, PhD*†

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Objective: To investigate the epidemiology and clinical spectrum of fever in HIV-infected returning travelers and migrants.

Methods: From April 2000 to December 2006, we explored prospectively, at our referral travel/HIV clinics, the etiology and outcome of febrile illnesses developing within 3 months after a stay in the tropics. For this study, we compared the morbidity profile between HIV-infected individuals and all other cases tested HIV negative.

Results: Of the 1850 adults (15 years and older) evaluated for 1921 fever episodes, 93 (5%) had HIV infection, including 5 presenting with primary infection. HIV prevalence was 2% in western travelers or expatriates, 11% in travelers “visiting friends and relatives,” and 24% in foreign visitors/migrants. Fever episodes (n = 104) occurring in the HIV-infected individuals were mainly due to opportunistic infections (23%, including tuberculosis), respiratory tract infections (20%), sexually transmitted infections (9%), and noninfectious diseases (7%). All these conditions were more frequently diagnosed than in HIV-negative travelers (1035 fever episodes), although tropical infections (mostly malaria) were proportionally less prevalent. Morbidity (rate and duration of hospitalization) was more considerable in HIV-infected patients than in HIV-negative individuals.

Conclusions: HIV infection was frequent in returning travelers and migrants presenting with fever at our setting and affected strongly the diagnostic spectrum and overall morbidity.

© 2008 Lippincott Williams & Wilkins, Inc.


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