Progression to AIDS in homosexual men infected with HIV in Trinidad: a 3«-year follow-up - abstract

ABSTRACT

One hundred healthy homosexual or bisexual men were enrolled in a study at a venereal disease clinic in Port-of-Spain in 1983 and 40 percent were found to be HIV sero-positive as compared to 0.19 percent in a comparison group from the general population. Sexual contact with men from the USA was found to be the most significant risk factor; prior history of gonorrhoea, a marker of sexual promiscuity, was also associated with HIV sero-positivity; 15 percent were sero-positive for HTLV-I, a six-fold increase over the rate in a comparison group from the general population. The duration of homosexuality and the number of sexual partners were both associated with HTLV-I sero-positivity, suggesting that this virus, like HIV, is transmitted by homosexual activity. Six subjects were co-infected with HIV and HTLV-I; markers of altered immune status were found to be most perturbed in this group when compared with those infected with HIV alone. Prospective evaluation of the cohort has revealed that, out of 34 men who were HIV positive alone, 3 (9 percent) have progressed to AIDS in 3« years. However, of the 6 men who were co-infected, 3 (50 percent) have progressed to AIDS in the same time. Trend analysis (Kaplin and Meier) of the dates of diagnosis of AIDS among study participants (n=40) revealed a significantly increased risk of development of AIDS among individuals co-infected with HIV and HTLV-I (50 percentñ20.4 percent) as compared with those infected with HIV alone (8.8 percentñ4.9 percent). This clinical finding supports the in-vitro observation that HTLV-I infection facilitates the expression of HIV in lymphocytes infected with both retroviruses (AU)