Three-year incidence of AIDS in five cohorts of HTLV-III-infected risk group members.
Three-year incidence of AIDS in five cohorts of HTLV-III-infected risk group members.
复制标题
五组 HTLV-III 感染风险组成员的三年艾滋病发病率。
作者：
J. Goedert;R. Biggar;S. Weiss;Eyster Me;M. Melbye;Susan E. Wilson;H. Ginzburg;R. Grossman;RA DiGioia;William C. Sanchez
在725名艾滋病（AIDS）高危人群中对感染人T淋巴细胞病毒Ⅲ型（HTLV - Ⅲ）者的艾滋病发病率进行了前瞻性评估，这些人在1982年10月之前参加了针对同性恋男性、注射吸毒者和血友病患者的队列研究。共有276名（38.1%）受试者在入组时HTLV - Ⅲ血清反应呈阳性，或随后产生了HTLV - Ⅲ抗体。到1985年8月，28名（10.1%）血清反应阳性的受试者患上了艾滋病。通过精算生存计算，在纽约曼哈顿的同性恋男性队列中，所有HTLV - Ⅲ血清反应阳性受试者的3年艾滋病发病率为34.2%，在其他四个队列中为14.9%（范围为8.0% - 17.2%）。在117名在有记录的血清转化后平均随访31个月的受试者中，5名（均为血友病患者）在估计的血清转化日期后28 - 62个月患上了艾滋病，这支持了在获得病毒感染和临床艾滋病发病之间存在较长潜伏期的假设。如果该病毒在进入其他队列所涉及的人群之前就已进入纽约的同性恋人群，那么这种长潜伏期可以解释纽约队列与其他队列相比艾滋病发病率显著较高的原因。然而，不同人群中艾滋病发病的风险可能还取决于尚未确定的辅助因素的存在。
The incidence of the acquired immune deficiency syndrome (AIDS) among persons infected with human T-lymphotropic virus type III (HTLV-III) was evaluated prospectively among 725 persons who were at high risk of AIDS and had enrolled before October 1982 in cohort studies of homosexual men, parenteral drug users, and hemophiliacs. A total of 276 (38.1 percent) of the subjects were either HTLV-III seropositive at enrollment or developed HTLV-III antibodies subsequently. AIDS had developed in 28 (10.1 percent) of the seropositive subjects before August 1985. By actuarial survival calculations, the 3-year incidence of AIDS among all HTLV-III seropositive subjects was 34.2 percent in the cohort of homosexual men in Manhattan, New York, and 14.9 percent (range 8.0 to 17.2 percent) in the four other cohorts. Out of 117 subjects followed for a mean of 31 months after documented seroconversion, five (all hemophiliacs) developed AIDS 28 to 62 months after the estimated date of seroconversion, supporting the hypothesis that there is a long latency between acquisition of viral infection and the development of clinical AIDS. This long latency could account for the significantly higher AIDS incidence in the New York cohort compared with other cohorts if the virus entered the New York homosexual population before it entered the populations from which the other cohorts were drawn. However, risk of AIDS development in different populations may also depend on the presence of as yet unidentified cofactors.