Long-term survivors with HIV-1 infection: Incubation period and longitudinal patterns of CD4+ lymphocytes

A. Munoz*, A. J. Kirby, Y. D. He, J. B. Margolick, B. R. Visscher, C. R. Rinaldo, R. A. Kaslow, J. P. Phair

*Corresponding author for this work

Research output: Contribution to journalArticle

101 Scopus citations

Abstract

To characterize long-term survival with HIV-1, we need to estimate the proportion of seroconverters remaining free from clinical AIDS for long periods. We predict that ~13% of homosexual/bisexual men infected at a young age may remain so for >20 years. Since studies have not followed individuals for such periods, long-term survivors must be characterized using stability of immunologic markers. In a cohort of 1,809 seropositive men followed since 1984-85, 15% (187/1,214) of those with at least two consecutive visits early in the study showed no decline in CD4+ cell count. From these, 67 men with long follow-up and no use of zidovudine were identified as cases to investigate correlates of protection against HIV-1-induced immunodepletion. Two matched control subgroups, one with moderate and one with rapid CD4+ lymphocyte decline, produced 56 triplets of individuals to be contrasted. Analysis of data from early in the study on demographics, sexual behavior, and sexually transmitted diseases revealed no significant differences among the three groups. Men showing no decline in CD4+ lymphocytes persistently showed a healthier profile with respect to onset of clinical AIDS, survival, and concomitant hematologic variables. Moderate decliners had rates of clinical AIDS and death significantly higher than those in the stable group but lower than the fast decliners.

Original languageEnglish (US)
Pages (from-to)496-505
Number of pages10
JournalJournal of Acquired Immune Deficiency Syndromes and Human Retrovirology
Volume8
Issue number5
DOIs
StatePublished - Jan 1 1995

Keywords

  • CD4 lymphocytes
  • Incubation period
  • Statistical models
  • Study design

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Virology

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