title: The natural history of HIV-1 infection in young Thai men after seroconversion.
abstract: The natural history and progression of HIV-1 infection in Thailand and other developing countries in Asia and Africa have not been well defined. Nevertheless, valid data are needed to evaluate the effects of interventions, which are designed to delay progression. We evaluated the progression to AIDS and death in 235 men who seroconverted during their 2 years of service in the Royal Thai Army. The men were conscripted at age 21 and seroconverted within a 6-month window during follow-up while in the military. The seroconverters were matched with men who were seronegative when discharged. Of the HIV-positive men, 156 (66.4%) were alive, 77 (32.8%) had died, and 2 (0.8%) could not be located 5-7 years after their seroconversion and discharge from the military. The 5-year survival rate was 82.3%; the median times to clinical AIDS and a CD4 cell count of <200/microL was 7.4 years and 6.9 years, respectively. The mortality rate was 56.3 deaths per 1000 patient-years for HIV-positive men and 6.1 deaths per 1000 patient-years for HIV-negative men. Our data suggest a more rapid progression to AIDS and death after HIV-1 infection in young men in Thailand than has been reported for similarly aged cohorts in developed countries.
authors.affiliation: Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok, Thailand.
authors.forename: Ram
authors.initials: R
authors.lastname: Rangsin
authors.forename: Joseph
authors.initials: J
authors.lastname: Chiu
authors.forename: Chirasak
authors.initials: C
authors.lastname: Khamboonruang
authors.forename: Narongrid
authors.initials: N
authors.lastname: Sirisopana
authors.forename: Sakol
authors.initials: S
authors.lastname: Eiumtrakul
authors.forename: Arthur E
authors.initials: AE
authors.lastname: Brown
authors.forename: Merlin
authors.initials: M
authors.lastname: Robb
authors.forename: Chris
authors.initials: C
authors.lastname: Beyrer
authors.forename: Cholticha
authors.initials: C
authors.lastname: Ruangyuttikarn
authors.forename: Lauri E
authors.initials: LE
authors.lastname: Markowitz
authors.forename: Kenrad E
authors.initials: KE
authors.lastname: Nelson
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000503:physiopathology; D000293:Adolescent; D000328:Adult; D018791:CD4 Lymphocyte Count; D006679:HIV Seropositivity / Q000401:mortality / Q000503:physiopathology*; D015497:HIV-1; D006801:Humans; D008297:Male; D012367:RNA, Viral / Q000097:blood; D016019:Survival Analysis; D013785:Thailand; D019562:Viral Load
chemical_list: D012367:RNA, Viral