LONG-TERM HIV-1 INFECTION WITHOUT IMMUNOLOGICAL PROGRESSION

被引:311
作者
BUCHBINDER, SP [1 ]
KATZ, MH [1 ]
HESSOL, NA [1 ]
OMALLEY, PM [1 ]
HOLMBERG, SD [1 ]
机构
[1] CTR DIS CONTROL & PREVENT, NATL CTR INFECT DIS, DIV HIV AIDS, ATLANTA, GA 30341 USA
关键词
NONPROGRESSORS; LONG-TERM SURVIVAL; ASYMPTOMATIC HIV INFECTION; BEHAVIORAL COFACTORS; CD4; SLOPE; LABORATORY MARKERS;
D O I
10.1097/00002030-199408000-00014
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Objective: To identify and describe a subgroup of men infected with HIV for 10-15 years without immunologic progression, and to evaluate the effect of sexually transmitted diseases (STD) and recreational drug use on delayed HIV disease progression. Design: Inception cohort study. Setting: Municipal STD clinic. Participants: A total of 588 men with well documented dates of HIV seroconversion and 197 HIV-seronegative controls. Main outcome measures: AIDS, CD4+ count, rate of CD4+ cell loss, CD8+ count, beta(2)-microglobulin, complete blood count, p24 antigen and HIV-related symptoms. Results: Of 588 men, 69% had developed AIDS by 14 years after HIV seroconversion (95% confidence interval, 64-73%). Of 539 men with HIV seroconversion dates prior to 1983, 42 men (8%) were healthy long-term HIV-positives (HLP), HIV-infected greater than or equal to 10 years without AIDS and with CD4+ counts > 500 x 10(6)/l. When compared with progressors (men with HIV seroconversion prior to 1983 but with AIDS or CD4+ counts < 200 x 10(6)/l), HLP had a significantly slower rate of CD4+ decline (6 versus 85 x 10(6)/l cells/year), and less abnormal immunologic, hematologic and clinical parameters. However, when compared with HIV-uninfected controls, HLP demonstrated lower CD4+ counts and mild hematologic abnormalities. There were no consistent differences between HLP and progressors in prior exposure to recreational drugs or STD. Conclusion: There are individuals with long-term HIV infection who appear clinically and immunologically healthy 10-15 years after HIV seroconversion, with stable CD4+ counts. Lack of exposure to STD or recreational drugs does not appear to explain the delayed course of disease progression in HLP.
引用
收藏
页码:1123 / 1128
页数:6
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