0
November 11, 1988, Vol 260, No. 18 >
ARTICLE | November 11, 1988

A Six-Year Follow-up of HIV-Infected Homosexual Men With Lymphadenopathy: Title and subTitle BreakEvidence for an Increased Risk for Developing AIDS After the Third Year of Lymphadenopathy FREE

Jonathan E. Kaplan, MD; Thomas J. Spira, MD; Daniel B. Fishbein, MD; Lorna H. Bozeman, MS; Paul F. Pinsky, MPH; Lawrence B. Schonberger, MD
[+] Author Affiliations

Reprint requests to Division of Viral Diseases, Bldg 6, Room 127, Centers for Disease Control, Atlanta, GA 30333 (Dr Kaplan).


JAMA. 1988;260(18):2694-2697. doi:10.1001/jama.1988.03410180102038
Text Size: A A A
Published online
Article
References

Seventy-five homosexual men with generalized lymphadenopathy for at least three months (lymphadenopathy syndrome [LAS]), subsequently shown to be seropositive for antibody against human immunodeficiency virus, were enrolled in a prospective study in Atlanta in 1982 and 1983. As of Nov 30,1987, twenty-two (29%) of the 75 were known to have developed acquired immunodeficiency syndrome (AIDS) three to 60 months after enrollment and five to 69 months after onset of LAS. The six-year cumulative incidence of AIDS, by Kaplan-Meier survival analysis, was 38%. The cumulative incidence in years 4,5, and 6 (30%) was significantly higher than in years 1, 2, and 3 (11%), suggesting that the risk for AIDS increases after the third year of LAS and that many more study participants will eventually develop AIDS. A precipitous decline in the T-helper cell count frequently heralds the diagnosis of AIDS; this decrease appears to occur at different times after the onset of LAS in different persons. The four-year cumulative incidence of AIDS following observations of T-helper cell counts less than 200/mm3, 200 to 299/mm3, 300 to 399/mm3, and 400/mm3 or greater was 84%, 41%, 25%, and 18%, respectively; these data are important for determining prognosis in the individual patient as well as for determining the suitability of candidates and baseline data for drug trials.

(JAMA 1988;260:2694-2697)

REFERENCES

1 +
Goedert JJ, Biggar RJ, Weiss SH, et al:  Three-year incidence of AIDS in five cohorts of HTLV-III-infected risk group members . Science 1986;;231:992-995.
2 +
Curran JW, Jaffe HW, Hardy AM, et al:  Epidemiology of HIV infection and AIDS in the United States . Science 1988;;239:610-616.
3 +
Holzman RS, Walsh CM, Karpatkin S:  Risk for the acquired immunodeficiency syndrome among thrombocytopenic and nonthrombocytopenic homosexual men seropositive for the human immunodeficiency virus . Ann Intern Med 1987;;106:383-386.
4 +
Goedert JJ, Biggar RJ, Melbye M, et al:  Effect of T4 count and cofactors on the incidence of AIDS in homosexual men infected with human immunodeficiency virus . JAMA 1987;;257:331-334.
5 +
Eyster ME, Gail MH, Ballard JO, et al:  Natural history of human immunodeficiency virus infections in hemophiliacs: Effects of T-cell subsets, platelet counts, and age . Ann Intern Med 1987;;107:1-6.
6 +
Mathur-Wagh U, Mildvan D, Senie RT:  Follow-up at 4 1/2 years on homosexual men with generalized lymphadenopathy . N Engl J Med 1985;;313:1542-1543.
7 +
Fishbein DB, Kaplan JE, Spira TJ, et al:  Unexplained lymphadenopathy in homosexual men: A longitudinal study . JAMA 1985;;254:930-935.
8 +
Kaplan JE, Spira TJ, Fishbein DB, et al:  Lymphadenopathy syndrome in homosexual men: Evidence for continuing risk of developing the acquired immunodeficiency syndrome . JAMA 1987;;257:335-337.
9 +
 Single-sample nonparametric methods , in Cox DR, Oakes D (eds): Analysis of Survival Data . New York, Chapman & Hall, 1984;, chap 4.
10 +
Medley GF, Anderson RM, Cox DR, et al:  Incubation period of AIDS in patients infected via blood transfusion . Nature 1987;;328:719-721.
11 +
Mathur-Wagh U, Enlow RW, Spigland I, et al:  Longitudinal study of persistent generalised lymphadenopathy in homosexual men: Relation to acquired immunodeficiency syndrome . Lancet 1984;; 1:1033-1038.
12 +
El Sadr W, Marmor M, Zolla-Pazner S, et al:  Four-year prospective study of homosexual men: Correlation of immunologic abnormalities, clinical status, and serology to human immunodeficiency virus . J Infect Dis 1987;;155:789-793.
13 +
Polk BF, Fox R, Brookmeyer R, et al:  Predictors of the acquired immunodeficiency syndrome developing in a cohort of seropositive homosexual men . N Engl J Med 1987;;316:61-66.
14 +
Schechter MT, Boyko WJ, Craib KJP, et al:  Effects of long-term seropositivity to human immunodeficiency virus in a cohort of homosexual men . AIDS 1987;;1:77-82.
15 +
Melbye M, Biggar RJ, Ebbesen P, et al:  Long-term seropositivity for human T-lymphotropic virus type III in homosexual men without the acquired immunodeficiency syndrome: Development of immunologic and clinical abnormalities . Ann Intern Med 1986;;104:496-500.

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Goedert JJ, Biggar RJ, Weiss SH, et al:  Three-year incidence of AIDS in five cohorts of HTLV-III-infected risk group members . Science 1986;;231:992-995.
2 +
Curran JW, Jaffe HW, Hardy AM, et al:  Epidemiology of HIV infection and AIDS in the United States . Science 1988;;239:610-616.
3 +
Holzman RS, Walsh CM, Karpatkin S:  Risk for the acquired immunodeficiency syndrome among thrombocytopenic and nonthrombocytopenic homosexual men seropositive for the human immunodeficiency virus . Ann Intern Med 1987;;106:383-386.
4 +
Goedert JJ, Biggar RJ, Melbye M, et al:  Effect of T4 count and cofactors on the incidence of AIDS in homosexual men infected with human immunodeficiency virus . JAMA 1987;;257:331-334.
5 +
Eyster ME, Gail MH, Ballard JO, et al:  Natural history of human immunodeficiency virus infections in hemophiliacs: Effects of T-cell subsets, platelet counts, and age . Ann Intern Med 1987;;107:1-6.
6 +
Mathur-Wagh U, Mildvan D, Senie RT:  Follow-up at 4 1/2 years on homosexual men with generalized lymphadenopathy . N Engl J Med 1985;;313:1542-1543.
7 +
Fishbein DB, Kaplan JE, Spira TJ, et al:  Unexplained lymphadenopathy in homosexual men: A longitudinal study . JAMA 1985;;254:930-935.
8 +
Kaplan JE, Spira TJ, Fishbein DB, et al:  Lymphadenopathy syndrome in homosexual men: Evidence for continuing risk of developing the acquired immunodeficiency syndrome . JAMA 1987;;257:335-337.
9 +
 Single-sample nonparametric methods , in Cox DR, Oakes D (eds): Analysis of Survival Data . New York, Chapman & Hall, 1984;, chap 4.
10 +
Medley GF, Anderson RM, Cox DR, et al:  Incubation period of AIDS in patients infected via blood transfusion . Nature 1987;;328:719-721.
11 +
Mathur-Wagh U, Enlow RW, Spigland I, et al:  Longitudinal study of persistent generalised lymphadenopathy in homosexual men: Relation to acquired immunodeficiency syndrome . Lancet 1984;; 1:1033-1038.
12 +
El Sadr W, Marmor M, Zolla-Pazner S, et al:  Four-year prospective study of homosexual men: Correlation of immunologic abnormalities, clinical status, and serology to human immunodeficiency virus . J Infect Dis 1987;;155:789-793.
13 +
Polk BF, Fox R, Brookmeyer R, et al:  Predictors of the acquired immunodeficiency syndrome developing in a cohort of seropositive homosexual men . N Engl J Med 1987;;316:61-66.
14 +
Schechter MT, Boyko WJ, Craib KJP, et al:  Effects of long-term seropositivity to human immunodeficiency virus in a cohort of homosexual men . AIDS 1987;;1:77-82.
15 +
Melbye M, Biggar RJ, Ebbesen P, et al:  Long-term seropositivity for human T-lymphotropic virus type III in homosexual men without the acquired immunodeficiency syndrome: Development of immunologic and clinical abnormalities . Ann Intern Med 1986;;104:496-500.

Letters

Submit a Letter
CME Course for:


You need to register in order to view this quiz.


To understand the clinical management of acute heart failure syndromes.
Accreditation Information The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
To view and print your certificate and access a summary of your CME courses go to My CME.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Compression-Only CPR: Pushing the Science Forward
Cone
AAM 2010;304:1493-1495.
All you need to read in the other general journals
BMJ 2010;341:c5893-c1494.
Submit a Response

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

© 2012 American Medical Association. All Rights Reserved.
Powered bySilverchair Information Systems