Three-Year Incidence of AIDS in Five Cohorts of HTLV-III-Infected Risk Group Members

Abstract

The incidence of the acquired immune deficiency syndrome (AIDS) among persons infected with human T-lymphotropic virus type III (HTLV-III) was evaluated prospectively among 725 persons who were at high risk of AIDS and had enrolled before October 1982 in cohort studies of homosexual men, parenteral drug users, and hemophiliacs. A total of 276 (38.1 percent) of the subjects were either HTLV-III seropositive at enrollment or developed HTLV-III antibodies subsequently. AIDS had developed in 28 (10.1 percent) of the seropositive subjects before August 1985. By actuarial survival calculations, the 3-year incidence of AIDS among all HTLV-III seropositive subjects was 34.2 percent in the cohort of homosexual men in Manhattan, New York, and 14.9 percent (range 8.0 to 17.2 percent) in the four other cohorts. Out of 117 subjects followed for a mean of 31 months after documented seroconversion, five (all hemophiliacs) developed AIDS 28 to 62 months after the estimated date of seroconversion, supporting the hypothesis that there is a long latency between acquisition of viral infection and the development of clinical AIDS. This long latency could account for the significantly higher AIDS incidence in the New York cohort compared with other cohorts if the virus entered the New York homosexual population before it entered the populations from which the other cohorts were drawn. However, risk of AIDS development in different populations may also depend on the presence of as yet unidentified cofactors.

Mixed Genotypes in Hepatitis C Virus Infection

“…As reported in different cohorts around the world, many patients with hemophilia became infected with HIV between 1982 and 1985. In some hemophilic populations, subsequent testing of stored frozen plasma samples revealed that the first infections with HIV occurred in 1978-79, that the bulk of patients were infected in 1981-82, and that there were very few new infections by the end of 1984 (Eyster, 2008;Goedert et al, 1985). The HCV epidemic was a much longer one, occurring between 1961 and 1985.…”

Human immunodeficiency virus and acquired immunodeficiency syndrome: correlation but not causation.

“…It is on the basis of the relatively high conversion rates of these risk groups that every asymptomatic infection by HIV is now being called "HIV disease" (7), and that some are subjected to chemotherapy (39). Nevertheless, individual asymptomatic periods are unpredictable, ranging from <1 to >15 years (22,(33)(34)(35)(36)(37)(38). Once AIDS is diagnosed, the mean life expectancy is about 1 year (35).…”

“…Moreover, the AIDS risk of an antibody-positive American varies a great deal with his or her risk group. For example, 3-25% of antibody-positive Americans who habitually practice risk behavior or are hemophiliacs develop AIDS annually (7,21,22,(33)(34)(35)(36)(37)(38). Thus, the 1.5% annual conversion rate of antibody-positive Americans is an average of minorities with high conversion rates of 3-25% and a majority with a conversion rate close to %o.…”

Heat-shock Induction of the Human Immunodeficiency Virus Long Terminal Repeat

“…HIV infection is characterized by a prolonged period of latency, which may be followed by AIDS or AIDS-related complex (Goedert et al, 1986). Progression to AIDS has been associated with the detection of HIV core antigen in serum Lange et al, 1986) indicating a role for enhanced HIV gene expression in the pathogenesis of HIV.…”