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Evidence for an Increased Risk for Developing AIDS After the Third Year of Lymphadenopathy

Jonathan E. Kaplan, MD; Thomas J. Spira, MD; Daniel B. Fishbein, MD; Lorna H. Bozeman, MS; Paul F. Pinsky, MPH; Lawrence B. Schonberger, MD

JAMA. 1988;260(18):2694-2697.

Abstract
Seventy-five homosexual men with generalized lymphadenopathy for at least three months (lymphadenopathy syndrome [LAS]), subsequently shown to be seropositive for antibody against human immunodeficiency virus, were enrolled in a prospective study in Atlanta in 1982 and 1983. As of Nov 30,1987, twenty-two (29%) of the 75 were known to have developed acquired immunodeficiency syndrome (AIDS) three to 60 months after enrollment and five to 69 months after onset of LAS. The six-year cumulative incidence of AIDS, by Kaplan-Meier survival analysis, was 38%. The cumulative incidence in years 4,5, and 6 (30%) was significantly higher than in years 1, 2, and 3 (11%), suggesting that the risk for AIDS increases after the third year of LAS and that many more study participants will eventually develop AIDS. A precipitous decline in the T-helper cell count frequently heralds the diagnosis of AIDS; this decrease appears to occur at different times after the onset of LAS in different persons. The four-year cumulative incidence of AIDS following observations of T-helper cell counts less than 200/mm³, 200 to 299/mm³, 300 to 399/mm³, and 400/mm³ or greater was 84%, 41%, 25%, and 18%, respectively; these data are important for determining prognosis in the individual patient as well as for determining the suitability of candidates and baseline data for drug trials.

(JAMA 1988;260:2694-2697)

Author Affiliations
From the Division of Viral Diseases and the Division of Host Factors, Center for Infectious Diseases, Centers for Disease Control, Atlanta.

Footnotes
Reprint requests to Division of Viral Diseases, Bldg 6, Room 127, Centers for Disease Control, Atlanta, GA 30333 (Dr Kaplan).

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