The incidence and epidemiology of human immunodeficiency virus infection in 320 patients treated in an inner-city hemodialysis center.
From January 1, 1986 through June 30, 1989, 320 maintenance hemodialysis patients treated at The Brookdale Hospital Medical Center were tested for the presence of antibody to the human immunodeficiency virus (HIV) using the enzyme-linked immunosorbent assay (ELISA) and Western blot assays. Thirty-nine patients (12%) tested positive for HIV antibody (HIV+) with both the ELISA and Western blot, 24 (62%) of whom were known intravenous drug abusers (IVDA). Of the remaining non-IVDA patients, unanticipated HIV+ results were found in 10 (25%). Thirty-four (87%) of the 39 HIV+ patients were asymptomatic at the start of the study, while two had acquired immunodeficiency syndrome (AIDS) and three others, AIDS-related complex (ARC). Four patients subsequently developed AIDS 20 +/- 4.9 weeks (range, 12 to 32) after testing, three of whom initially had ARC. One patient developed ARC 7 months after testing. Sixteen HIV+ patients died, including five of the six with AIDS, one with ARC, and two others from Mycobacterium tuberculosis. The eight other deaths were from causes unrelated to HIV disease and occurred 12 +/- 2.3 months (range, 1 to 24) after testing. Two HIV+ patients were lost to follow-up. Twenty-one HIV+ patients (54%) are alive and 20 (51%) asymptomatic 15 +/- 2.4 months (range, 1 to 42) after HIV testing. Thus, despite HIV positivity, 28 patients (72%) had an asymptomatic period lasting 14 +/- 1.9 months (range, 1 to 42). Seventy-two of the 281 HIV-negative (HIV-) patients died during the study. None of the HIV- patients manifested ARC or AIDS, confirming that there was no false-negative HIV test.(ABSTRACT TRUNCATED AT 250 WORDS)
Reiser
I W
IW
Department of Medicine, Brookdale Hospital Medical Center, Brooklyn, NY 11212.
Shapiro
W B
WB
Porush
J G
JG
D015492:AIDS Serodiagnosis; D000386:AIDS-Related Complex / Q000453:epidemiology; D000163:Acquired Immunodeficiency Syndrome / Q000453:epidemiology* / Q000401:mortality; D000328:Adult; D015153:Blotting, Western; D003955:Diagnostic Tests, Routine; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006436:Hemodialysis Units, Hospital / Q000706:statistics & numerical data*; D006757:Hospital Units / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007674:Kidney Diseases / Q000150:complications / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D011379:Prognosis; D012307:Risk Factors; D015819:Substance Abuse, Intravenous / Q000150:complications; D015996:Survival Rate