3rd International AIDS Conference Washington, DC, U.S.A. — June 1-5, 1987

Int Conf AIDS. 1987 Jun 1-5;3: Abstract No. M.3.4

Peter A Selwyn¹, EE Schoenbaum¹, D Hartel¹, T Peterman², RS Klein¹, GH Friedland¹, et al.
¹Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, ²CDC, Atlanta, GA, USA.

We are prospectively studying patients in a methadone maintenance program in NYC to characterize the natural history of HIV infection in this group of IVDAS. From 7/85-4/86, 498 patients enrolled in an HIV seroprevalence study; we now present preliminary follow-up data. All subjects had an initial interview regarding drug use and sexual behavior, serum was obtained for HIV antibody (Ab) and a physicial exam was performed. Rescreening visits are scheduled semi-annually, with interview, repeat Ab test, and exam. All patients receive on-site primary care and are monitored by clinical staff for the occurrence of AIDS/HIV disease.

In the original group, there were 169 seropositives (SP) without AIDS, and 329 seronegatives (SN). 91 (54%) SPs were male; mean age was 33 yrs.; 17 (10%) were white (W), 54 (32%) black (B), 98 (58%) Hispanic (H). 5 of 6 SPs with oral thrush (OT) at study entry developed AIDS at a mean of 4.7 mos. follow-up. 163 SPs with-out OT have been followed for a median of 15 months (range 10-20). Of these, 6 (3.7%) developed AIDS and 2 (1.2.%) presumptive AIDS at a mean of 12.3 mos. follow-up. Among SPs without OT, cumulative incidence of AIDS was thus ^.5%, with 2.7 cases/1000 person-months follow-up. Of 13 cases of AIDS/presumptive AIDS, 8 (62%) were male; mean age 34 yrs.; 1 was W (8%), 6 B (46%), 6 H (46%). Multiple logistic regression analysis including demographic, drug use, and sexual variables from initial interview data indicated that black race (p(.O1), prostitution (p(.02), and drug use in a "shooting gallery" (p(.03) were all predictive of the development of AIDS among SPs. 44/169 (26%) original SPs have been formally re-screened to date. 5/44 (11%) had new generalized lymphadenopathy on exam and 2/44 (5%) had new OT at a median of 14 mos. follow-up.

Results indicate that HIV-infected IVDAS progress to clinical disease at a substantial rate; AIDS was predicted by certain drug use and sexual behaviors. The observed association with race requires further explanation.

870601
M.3.4

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