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1994-10-25
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Document 2678
DOCN M94A2678
TI HIV-1 syncytium-inducing phenotype does not predict AIDS in a cohort of
injecting drug users in contrast with findings in homosexual men.
DT 9412
AU Spijkerman IJ; Koot M; Prins M; Mientjes GH; van den Hoek JA; Miedema F;
Coutinho RA; Municipal Health Service, Amsterdam, The Netherlands.
SO Int Conf AIDS. 1994 Aug 7-12;10(1):25 (abstract no. 075C). Unique
Identifier : AIDSLINE ICA10/94369897
AB OBJECTIVE: The prognostic value of syncytium-inducing (SI) phenotype of
the human immunodeficiency virus type 1 (HIV-1) has mainly been studied
in homosexual men. We studied the prevalence, incidence and prognostic
value for progression to AIDS of the HIV-1 SI phenotype in a group of
HIV-1 infected injecting drug users (IDU). METHODS: A prospective study
of HIV-1 infected IDU without AIDS (n = 192) was carried out during a
4.5-year follow-up period. Every 4 months the participants were tested
for the presence of SI variants and studied for progression to AIDS (CDC
'87). SI variants were detected by cocultivation of peripheral blood
mononuclear cells with the MT-2 T-cell line. RESULTS: SI-variants were
detected in 6 out of 192 participants at the beginning of the study
period (3.1%), and 16 participants switched from NSI to SI variants
(cumulative incidence after 4 years 13.7%, 95% CI 8.4-22 12.1). Of the
192 IDU, 24 progressed to AIDS. Of 12 AIDS cases the viral phenotype was
known at the time of AIDS diagnosis; 2 AIDS cases had the SI phenotype
(17%) and 10 cases the NSI phenotype. In the remaining 12 AIDS cases NSI
variants were present at the last visit before AIDS was diagnosed (in 8
cases within 0.5 year before AIDS). Cox proportional Hazard analysis
showed that the SI phenotype did not predict AIDS while low CD4+ cell
count at baseline did. The switch from NSI to SI phenotype (n = 16)
occurred at a mean CD4+ cell count of 0.32 * 10(9)/L (95% CI 0.23-0.41).
DISCUSSION: A comparative study in our cohort of homosexual men (n =
225) has shown that the prevalence and incidence of SI phenotype is
higher among homosexual men. The most important difference, however, was
that the NSI/SI switch among IDU occurred at a lower CD4 level (0.32
compared to 0.48 (95% CI 0.42-0.54)). Furthermore 56% of the AIDS cases
among homosexual men had the SI phenotype compared to only 17% among
drug users at the time of AIDS diagnosis. In multivariate Cox
proportional hazard analysis the SI phenotype was an independent
predictor of AIDS among homosexual men but not in drug users.
DE Acquired Immunodeficiency Syndrome/EPIDEMIOLOGY/*MICROBIOLOGY Cohort
Studies Comparative Study Homosexuality Human HIV-1/*GENETICS
Incidence Male Netherlands/EPIDEMIOLOGY Phenotype Predictive Value
of Tests Prevalence Proportional Hazards Models Prospective Studies
*Substance Abuse, Intravenous MEETING ABSTRACT
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).