MORTALITY AMONG HIV-POSITIVE MILITARY SERVICE APPLICANTS

了解人类免疫缺陷病毒（HIV）的自然史 感染及其后遗症对于评估 建议的治疗和有效的咨询受影响的个人。 这项前瞻性研究的主要目的是检查自然 通过确定总死亡率和特定原因死亡率确定艾滋病毒感染史 在一个地理分布广泛的艾滋病毒抗体阳性的大型队列中， 个体在这一队列中，自杀死亡的风险是特殊的， 兴趣;只有轶事报告中的自杀风险， 无症状的艾滋病毒感染者，虽然艾滋病患者 自杀风险增加其他研究目的包括 研究特定原因死亡率的地理和时间差异 在研究人群中，并为正在进行的 基于血清阳性率信息的HIV发病率统计建模。 该研究组目前由2419名艾滋病毒抗体阳性的 已确定的个人（主要是年轻的成年男性） 自1985年10月以来，美国国防部在例行 对申请服兵役的平民进行筛选。一个对照组， 与血清阳性个体3：1匹配，从以下中选择C 血清反应阴性的申请人因其他原因被排除在兵役之外， 无关的医疗条件。其他血清阳性和血清阴性 研究小组每年增加受试者。研究死亡率 使用国家Z死亡指数确定受试者，该指数是一个中心指标， 包含每例死亡识别信息的计算机化索引 自1979年以来发生在美国。死因是基于死亡 从各州人口动态统计局获得的证明。死亡率 血清反应阳性受试者与血清反应阴性受试者进行比较 以及年龄、种族和性别特异性的美国死亡率。所有敏感 研究信息受到严格保密程序的保护。 研究队列的死亡率随访已完成至1987年， 目前正在为1988年进行。进一步的后续行动将提供例外情况， 血清阳性队列中生存率的有价值数据大于 其他地方可用。此应用程序请求支持额外的 对这一独特队列的五年死亡率随访。

Understanding the natural history of human immunodeficiency virus (HIV) infection and its sequelae is essential for assessing the impact of proposed therapies and for effective counseling of affected individuals. The primary objective of this prospective study is to examine the natural history of HIV infection by identifying total and cause-specific mortality in a large geographically diverse cohort of HIV-antibody positive individuals. The risk of death from suicide in this cohort is of special interest; only anecdotal reports are available on the risk of suicide among persons with asymptomatic HIV infection, although persons with AIDS are known to be at increased risk of suicide. Other study objectives include examining geographic and temporal differences in cause-specific mortality in the study population and contributing data to ongoing studies of statistical modeling of HIV incidence based on seroprevalence information. The study group currently consists of 2419 HIV-antibody positive individuals (predominantly young adult males) who have been identified since October 1985 by the U.S. Department of Defense during routine screening of civilian applicants for military service. A comparison group, matched 3:1 with the seropositive individuals, is selected C from among seronegative applicants excluded from military service due to other unrelated medical conditions. Additional seropositive and seronegative subjects are added to the study group annually. Mortality among study subjects is ascertained using the National Z Death Index which is a central computerized index containing identifying information for each death occurring in the United States since 1979. Cause of death is based on death certificates obtained from state vital statistics offices. Mortality rates for seropositive subjects are compared to those for seronegative applicants and to age-,C/) race- and sex-specific U.S. mortality rates. All sensitive study information is protected by strict confidentiality procedures. Mortality follow-up of the study cohort has been completed through 1987 and is now in progress for 1988. Further follow-up will provide exceptionally valuable data on survival in a seropositive cohort larger than that available elsewhere. This application requests support for an additional five years of mortality follow-up of this unique cohort.