Fever after a stay in the tropics: clinical spectrum and outcome in HIV-infected travelers and migrants

J Acquir Immune Defic Syndr. 2008 Aug 15;48(5):547-52. doi: 10.1097/QAI.0b013e31817bebc5.

Abstract

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.

MeSH terms

  • Adolescent
  • Adult
  • Emigrants and Immigrants
  • Fever / epidemiology*
  • Fever / etiology
  • Fever / virology
  • HIV Infections / epidemiology*
  • HIV Infections / physiopathology
  • Humans
  • Prevalence
  • Prospective Studies
  • Sexually Transmitted Diseases / epidemiology*
  • Sexually Transmitted Diseases / microbiology
  • Sexually Transmitted Diseases / virology
  • Travel*
  • Tropical Climate*