The natural history of human immunodeficiency virus infection in a haemophilic cohort

Abstract

112 haemophilic patients infected with HIV were followed up with clinical and laboratory assessment between 1 December 1979 and 30 November 1988. Sixty‐six (59%) of the patients developed HIV‐related clinical symptoms and 22(20%) developed AIDS. Twenty (18%) of the patients developed p24 antigenaemia. Amongst the 59 patients whose date of seroconversion could be estimated the calculated 8‐year cumulative incidence of AIDS was 40% (symptoms 73%). For the whole cohort of 112 patients, the median slope of linear regression of the absolute T4 lymphocyte count was steeper for those with AIDS (‐0.113 × 10⁹/1 per year) than for those without AIDS (‐0.054 × 10⁹/1 per year) (P < 0.02). While 15 cases of AIDS developed during 58 patient‐years of follow up after falling below a T4 lymphocyte count of 0.2 × 10⁹/1, only two cases occurred during 450 patient‐years before reaching this count. Thus the decline of the T4 lymphocyte count to 0.2 × 10⁹/1 may be an appropriate additional end‐point for the assessment of new treatments for asymptomatic patients infected with HIV.