Selective causes of fever in adult human immunodeficiency virus-infected patients relative to CD4+ cell counts.

Fever is a common finding in the patient who is infected with the human immunodeficiency virus. As immunocompetence wanes, febrile episodes become more common, although the virus itself is seldom the cause of the fever. A thorough evaluation, based on the history and physical findings and directed by the level of immunosuppression relative to the CD4+ cell count, provides the framework upon which an approach to this complex problem is based. Noninfectious causes of fever, for example, drug reactions or adverse effects or neoplasms, should be considered in the differential diagnosis. Finally, health care workers should discuss the diagnostic evaluation with the patient before starting the process, as some individuals may be reluctant to undergo such an investigation.