The Retroviral Rebound Syndrome may develop in a patient with HIV infection who discontinues effective antiretroviral therapy. Symptoms may mimic those of primary HIV infection and occur in conjunction with a marked increase in plasma HIV RNA.
Criteria:
(1) history of chronic HIV infection
(2) discontinuation of effective antiretroviral therapy
(3) clinical onset of a primary HIV syndrome within a few weeks therapy discontinuation
(4) marked increase in HIV RNA, with or without decline in absolute CD4 lymphocyte count
Clinical findings:
(1) fever
(2) fatigue
(3) pharyngitis
(4) lymphadenopathy
(5) rash
(6) unintended weight loss
(7) rarely multi-organ failure
Providing that resistance has not developed, restarting antiretroviral therapy results in:
(1) a decrease in clinical symptoms
(2) a decrease in plasma HIV RNA
(3) a rebound in the absolute CD4 lymphocyte count
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