title: Associations of age, immunosuppression, and AIDS among homosexual men in the Tricontinental Seroconverter Study.
abstract: To characterize the associations of age, immunosuppression, and AIDS outcomes, we evaluated serial measures of CD4+ lymphocytes from 376 homosexual men with documented dates of HIV-1 seroconversion registered in the Tricontinental Seroconverter Study. Using regression models and adjusting for variation within individuals, we found no association between age and the number of CD4+ lymphocytes at seroconversion or with CD4+ lymphocyte decline after seroconversion. Men who developed opportunistic infections had fewer CD4+ lymphocytes at the time of diagnosis compared with men who developed AIDS-defining Kaposi's sarcoma. Older age was significantly associated with higher numbers of CD4+ lymphocytes in individuals diagnosed with AIDS-defining Kaposi's sarcoma but was not significant for individuals with opportunistic infections. Because older age shortens the latency period of Kaposi's sarcoma and does not affect the CD4+ lymphocyte loss, it results in higher CD4+ lymphocytes at the time of diagnosis. These findings suggest distinct biologic mechanisms for various AIDS manifestations, which is important for clinical decision making and health care planning.
authors.affiliation: Municipal Health Service, Department of Public Health, Amsterdam, The Netherlands.
authors.forename: P J
authors.initials: PJ
authors.lastname: Veugelers
authors.forename: S A
authors.initials: SA
authors.lastname: Strathdee
authors.forename: J M
authors.initials: JM
authors.lastname: Kaldor
authors.forename: K A
authors.initials: KA
authors.lastname: Shafer
authors.forename: A R
authors.initials: AR
authors.lastname: Moss
authors.forename: M T
authors.initials: MT
authors.lastname: Schechter
authors.forename: P T
authors.initials: PT
authors.lastname: Schellekens
authors.forename: R A
authors.initials: RA
authors.lastname: Coutinho
authors.forename: G J
authors.initials: GJ
authors.lastname: van Griensven
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000276:immunology; D000163:Acquired Immunodeficiency Syndrome / Q000276:immunology*; D000328:Adult; D000368:Aged; D000375:Aging / Q000276:immunology*; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D018450:Disease Progression; D006679:HIV Seropositivity / Q000276:immunology; D015497:HIV-1; D018451:Homosexuality, Male; D006801:Humans; D007108:Immune Tolerance; D016483:Lymphoma, AIDS-Related / Q000276:immunology; D008297:Male; D008875:Middle Aged; D012514:Sarcoma, Kaposi / Q000276:immunology