High risk of HIV disease progression after infection through a sexual partner with AIDS.
OBJECTIVE
To investigate whether HIV-1 infection acquired through a severely immunodepressed sexual partner increases the risk of disease progression.


METHODS
A prospective cohort of patients infected through sexual contact at a known date and enrolled a few months (median, 2 months) after their first HIV-positive test. At enrolment, 12 subjects stated having had unprotected intercourse (anal or vaginal penetration) with a partner with AIDS within the 6 months prior to their first HIV-positive test. For the same period, 60 subjects stated having had unprotected intercourse with a partner, known to be HIV-positive, but who had not developed AIDS.


METHODS
The endpoint was the first occurrence of an HIV-related illness (group IV or AIDS, 1987 Centers for Disease Control and Prevention revised classification). Event-free survival curves since infection were constructed using the Kaplan-Meier method and compared by the log-rank test. The Cox model was used for multivariate analysis.


RESULTS
Disease progression was more rapid among the 12 subjects who stated having sex with a person with AIDS at a time close to infection, than among the other subjects (P = 0.03). Homosexuality and age at infection were also related to HIV disease progression. The adjusted relative risk of developing an HIV-related illness among those 12 subjects was 3.9 (95% confidence interval, 1.5-9.9).


CONCLUSIONS
Our results confirm the influence of virus-related factors on the onset of immunodepression in subjects infected through sexual contact.
Carré
N
N
INSERM U-292, Department of Pubic Health, Epidemiology and Human Reproduction, Paris, France.
Meyer
L
L
Boufassa
F
F
Deveau
C
C
Persoz
A
A
Rouzioux
C
C
Vildé
J L
JL
D000163:Acquired Immunodeficiency Syndrome / Q000635:transmission* / Q000821:virology; D000328:Adult; D000367:Age Factors; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D015658:HIV Infections / Q000517:prevention & control / Q000635:transmission*; D006679:HIV Seropositivity; D006716:Homosexuality; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D012747:Sexual Partners; D013997:Time Factors