LONG-TERM HIV-1 INFECTION WITHOUT IMMUNOLOGICAL PROGRESSION
LONG-TERM HIV-1 INFECTION WITHOUT IMMUNOLOGICAL PROGRESSION
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DOI：
10.1097/00002030-199408000-00014
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发表时间：
1994-08-01
期刊：
影响因子：
3.8
通讯作者：
HOLMBERG, SD
中科院分区：
文献类型：
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作者：
BUCHBINDER, SP;KATZ, MH;HOLMBERG, SD
目的：确定并描述一个感染HIV 10-15年而无免疫学进展的男性亚组，并评估性传播疾病（STD）和娱乐性药物使用对延迟HIV疾病进展的影响。设计：初始队列研究。设置：市STD诊所。参与者：共有588名男性有明确的艾滋病毒血清转换日期和197名艾滋病毒血清阴性对照。结果：在588名男性中，69%在HIV血清转换后14年内发展为AIDS（95%可信区间，64-73%）。在1983年之前有HIV血清转换的539名男性中，42名男性（8%）是健康的长期HIV阳性（HLP），HIV感染超过或等于10年，没有艾滋病，CD 4+计数> 500 × 10（6）/l。与进展者（1983年以前HIV血清转化但患有AIDS或CD 4+计数< 200 × 10（6）/l的男性）相比，HLP的CD 4+下降速度明显较慢（6 vs 85 × 10（6）/l细胞/年），免疫学、血液学和临床参数异常较少。然而，与未感染HIV的对照组相比，HLP表现出较低的CD 4+计数和轻度血液学异常。HLP和进展者之间没有一致的差异，在以前暴露于娱乐性药物或STD。结论：有长期HIV感染的人出现临床和免疫健康10-15年后，HIV血清转换，稳定的CD 4+细胞计数。缺乏STD或娱乐性药物暴露似乎不能解释HLP疾病进展延迟的原因。
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.