Predictors of rapid progression to AIDS in HIV-1 seroconverters.
OBJECTIVE
To determine whether at the time of HIV-1 seroconversion rapid progressors to AIDS and a low CD4+ count can be distinguished by the clinical presentation of primary HIV-1 infection and serological and immunological characteristics.


METHODS
Prospective cohort study on HIV-1 infection in homosexual men.


METHODS
The Municipal Health Service, Amsterdam, The Netherlands.


METHODS
One hundred and eight men who seroconverted for HIV-1 during follow-up.


METHODS
Progression to AIDS and progression to a CD4+ lymphocyte count < 200 x 10(6)/l.


RESULTS
Symptomatic primary HIV infection with fever and skin rash, absence of anti-HIV core and transient HIV p24 antigenemia were independent predictors of progression to AIDS at the time of HIV-1 seroconversion. A low CD4+ count immediately after seroconversion and the calendar year were independent predictors of progression to a low CD4+ count at the time of HIV-1 seroconversion.


CONCLUSIONS
Even in the earliest stage of HIV-1 infection a small group of individuals at high risk for rapid progression to AIDS can be recognized by the clinical presentation of primary HIV infection, the presence of HIV p24 antigenaemia and the absence of a serological response to HIV core protein.
Keet
I P
IP
Municipal Health Service, Department of Public Health and Environment, Amsterdam, The Netherlands.
Krijnen
P
P
Koot
M
M
Lange
J M
JM
Miedema
F
F
Goudsmit
J
J
Coutinho
R A
RA
D000163:Acquired Immunodeficiency Syndrome / Q000453:epidemiology / Q000209:etiology* / Q000276:immunology; D000328:Adult; D015496:CD4-Positive T-Lymphocytes; D015331:Cohort Studies; D016655:HIV Core Protein p24 / Q000097:blood; D006679:HIV Seropositivity / Q000097:blood / Q000453:epidemiology / Q000276:immunology*; D015497:HIV-1; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors
D016655:HIV Core Protein p24