AEGiS-3IAC: [M.3.3] PROGRESSION TO AIDS, PREDICTORS OF AIDS, AND SEROCONVERSION IN A COHORT OF HOMOSEXUAL MEN: RESULTS OF A FOUR YEAR PROSPECTIVE STUDY

3rd International AIDS Conference

Washington, DC, U.S.A. — June 1-5, 1987

[TITLE:] PROGRESSION TO AIDS, PREDICTORS OF AIDS, AND SEROCONVERSION IN A COHORT OF HOMOSEXUAL MEN: RESULTS OF A FOUR YEAR PROSPECTIVE STUDY

Int Conf AIDS. 1987 Jun 1-5;3: Abstract No. M.3.3

Martin T Schechter, WJ Boyko, MS Weaver, B douglas, B willoughby, WA McLeod, et al.
The Vancouver Lymphadenopathy-AIDS Study, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada

The Vancouver Lymphadenopathy-AIDS Study is an ongoing prospective study of over 600 homosexual men who were recruited through their GP's beginning in 11/82 and who have been seen since at roughly six-month intervals. A total of 323 men were seropositive at entry into the study. Through 11/86, a total of 36 cases of AIDS were diagnosed in this group, yielding a Kaplan-Meier (K-M) estimate for the 48 month cumulative incidence of AIDS of 18.6%. The following are the categories (and K-M estimates of the four-year incidence of AIDS) for the lab predictors of progression to AIDS:

CD4 count	<400 (33.6%)	CD4/CD8 ratio	<.75 (36.9%)	IgG	>1600 (26.0%)
	>400 (14.3%) p=.0001		>.75 (11.1%) p=.0001		<1600 (14.2%) p=.003
IgA	>250 (37.3%)	Clq binding	>8% (30.5%)	Hbg	<15.0 (28.4%)
	<250 (9.3%) p=.003		<<8% (6.1%) p=.034		>15.0 (7.2%) p=.029

Cox regression revealed that CD4 cell depletion, IgG elevation, and IgA elevation, were significant and independent predictors of progression to AIDS in seropositive homosexual men.

Of 345 men who were HIV negative at enrolment, 85 (25%) have seroconverted by the time of this analysis. The K-M estimate for the risk of seroconverting during 11/82-07/86 was 22.5%. The seroconversion rates during 5 successive 9 month periods from 11/82 to 07/86 were 4.4%, 9.1%, 5.2%, 4.3%, and 1.7%. Cox regression analysis revealed the following significant risk factors for seroconversion: number of sexual partners, receptive anal intercourse, history of gonorrhea, use of illicit drugs, and age below 30 in 11/82. That men under 30 were twice as likely to seroconvert as older men appears to be due to lesser modification of behavior in the younger group. In fact, the proportions of men in the age groups <30, 30-34, 35-39, and 40+, reporting a decrease in the annual number of sexual partners were 49%, 56%, 61%, and 68% respectively. Additional counselling about safer sexual practices should therefore be selectively directed to younger members of the gay population.

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M.3.3.