Effect of T4 count and cofactors on the incidence of AIDS in homosexual men infected with human immunodeficiency virus
J. J. Goedert, R. J. Biggar, M. Melbye, D. L. Mann, S. Wilson, M. H. Gail, R. J. Grossman, R. A. DiGioia, W. C. Sanchez, S. H. Weiss and al. et
We prospectively evaluated potential markers and cofactors for the acquired
immunodeficiency syndrome (AIDS) in 86 homosexual men who were seropositive
for human immunodeficiency virus antibodies. During three years of
follow-up, 19 men developed AIDS. Risk of AIDS was clearly predicted by the
total number of circulating OKT4-positive lymphocytes (T4 count) at
enrollment, while the corresponding T8 count was unrelated to subsequent
AIDS development. Subjects in Manhattan had a higher risk of Kaposi's
sarcoma than did subjects in Washington, DC, and the risk of AIDS tended to
increase with numerous homosexual partners. Several of 40 potential
cofactors defined ex post facto, including receptive fellatio, enemas,
methaqualone use, and high levels of antibody to hepatitis B surface
antigen, appeared to be associated with Kaposi's sarcoma but not with
Pneumocystis pneumonia. Our data suggest that potent cofactors for
Pneumocystis pneumonia were not prominent, pointing to the need for
effective drug therapies, particularly to reduce the high AIDS risk of
persons with human immunodeficiency virus infection and low T4 counts.
