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Ten-Year Follow-Up of HIV-Infected Homosexual Men with Lymphadenopathy Syndrome: Evidence for Continuing Risk of Developing AIDS

Kaplan Jonathan E.; Spira, Thomas J.; Fishbein, Daniel B.; Lynn, Henry S.
JAIDS Journal of Acquired Immune Deficiency Syndromes: June 1992
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Summary:Seventy-five homosexual men with lymphadenopathy syndrome (LAS), subsequently shown to be seropositive for the human immunodeficiency virus (HIV), were enrolled in a prospective study in Atlanta in 1982 and 1983. Subjects have been followed up at 3- to 6-month intervals with clinical and immunologic evaluations, including analysis of T-cell subsets. As of February 28, 1991, AIDS had developed in 36 (48%) of the 75 men. The AIDS cases continued to occur through the 10th year after onset of LAS; the 10-year cumulative incidence of AIDS was 56.6% (Kaplan-Meier survival analysis). Six-year incidence rates following the first observation of a T-helper cell count ≥500/mm3, 400–499/mm3, 300–399/mm3, 200–299/mm3, and <200/mm3 were 29, 35, 50, 58, and 88%, respectively. Among individual symptoms and signs, only thrush conferred a poorer prognosis (odds ratio = 5.80; 95% confidence interval, 2.93, 11.39, p < 0.001, Mantel-Byar analysis). The risk of AIDS persists 10 years after the onset of LAS. The AIDS incidence is related directly to T-helper cell depletion; with the exception of thrush, the presence or absence of symptoms and signs appears to be of lesser prognostic significance.

Address correspondence and reprint requests to Dr. J. E. Kaplan, Bldg 6, Rm 279, Centers for Disease Control, Atlanta, GA 30333, U.S.A.

Manuscript received July 5, 1991; accepted October 29, 1991.

© Lippincott-Raven Publishers.