Keet I, Krijnen P, Koot M, Lange JM, Goudsmit J, Miedema F, Coutinho RA; International Conference on AIDS.

Int Conf AIDS. 1992 Jul 19-24; 8: Mo22 (abstract no. MoC 0085).

Municipal Health Service, Amsterdam, The Netherlands.

OBJECTIVES: To analyse if rapid progressors to AIDS can already be identified around the period of HIV seroconversion. METHODS: In a prospective study 763 HIV negative homosexual men were seen at 3-6 monthly intervals since 1984, of whom 108 men seroconverted for HIV during follow up. In these 108 men we studied if the following variables within the period of 6 months before and 6 months after seroconversion are predictors for subsequent rapid progression to AIDS: CD4 count before and after seroconversion, transient HIV p24 antigenaemia, detectable anti-HIV core and anti-HIV IgM, primary HIV infection with the combination of fever greater than 3 days and skin rash, having had sex with an AIDS patient before seroconversion, syncytium inducing HIV variants, calendar year of seroconversion and age. RESULTS: Of the 108 seroconverters 28 developed AIDS during follow up (4 years progression rate 20%). Significant predictors (% of total number seroconverters with characteristic) for rapid progression to AIDS in Kaplan Meier analysis were: CD4 count less than 700 before seroconversion (44%), absence of anti-HIV core (8%) fever with skin rash (12%) and having had sex with an AIDS patient (10%). A trend (p = 0.07) was found for transient HIV p24 antigenaemia (9%). Syncytium inducing HIV variants were detectable in 2 men of whom one progressed to AIDS and the other developed a CD4+ count less than 200 within 9 months. With Cox regression two independent predictors for progression to AIDS were found: fever with skin rash (relative hazard 4.4, p = 0.005) and detectable anti-HIV core (relative hazard 0.39, p = 0.009). CONCLUSION: These data show that already around the moment of HIV seroconversion a small group of rapid progressors to AIDS can be identified by the clinical presentation of the primary HIV infection and the serological response to HIV core. Syncytium inducing variants of HIV directly after seroconversion are rarely detected and associated with a very poor prognosis.

Publication Types:

• Meeting Abstracts

Keywords:

• AIDS Vaccines
• Acquired Immunodeficiency Syndrome
• Anti-HIV Agents
• CD4 Lymphocyte Count
• Disease Progression
• Exanthema
• Fever
• HIV
• HIV Antibodies
• HIV Core Protein p24
• HIV Infections
• HIV Seropositivity
• Humans
• Male
• Prospective Studies
• Virion
• immunology

Other ID:

• 92400044

UI: 102197757

From Meeting Abstracts