Rangsin Ram, Chiu Joseph, Khamboonruang Chirasak, Sirisopana Narongrid, Eiumtrakul Sakol, Brown Arthur E, Robb Merlin, Beyrer Chris, Ruangyuttikarn Cholticha, Markowitz Lauri E, Nelson Kenrad E
Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok, Thailand.
J Acquir Immune Defic Syndr. 2004 May 1;36(1):622-9. doi: 10.1097/00126334-200405010-00011.
The natural history and progression of HIV-1 infection in Thailand and other developing countries in Asia and Africa have not been well defined. Nevertheless, valid data are needed to evaluate the effects of interventions, which are designed to delay progression. We evaluated the progression to AIDS and death in 235 men who seroconverted during their 2 years of service in the Royal Thai Army. The men were conscripted at age 21 and seroconverted within a 6-month window during follow-up while in the military. The seroconverters were matched with men who were seronegative when discharged. Of the HIV-positive men, 156 (66.4%) were alive, 77 (32.8%) had died, and 2 (0.8%) could not be located 5-7 years after their seroconversion and discharge from the military. The 5-year survival rate was 82.3%; the median times to clinical AIDS and a CD4 cell count of <200/microL was 7.4 years and 6.9 years, respectively. The mortality rate was 56.3 deaths per 1000 patient-years for HIV-positive men and 6.1 deaths per 1000 patient-years for HIV-negative men. Our data suggest a more rapid progression to AIDS and death after HIV-1 infection in young men in Thailand than has been reported for similarly aged cohorts in developed countries.
在泰国以及亚洲和非洲的其他发展中国家，HIV-1感染的自然史和病程尚未得到明确界定。然而，需要有效的数据来评估旨在延缓病程的干预措施的效果。我们对235名在泰国皇家军队服役两年期间血清转化的男性的艾滋病进展和死亡情况进行了评估。这些男性在21岁时应征入伍，并在服役期间的随访6个月窗口期内发生血清转化。血清转化者与退伍时血清学阴性的男性进行匹配。在HIV阳性男性中，156人（66.4%）存活，77人（32.8%）死亡，2人（0.8%）在血清转化和退伍5至7年后无法找到。5年生存率为82.3%；临床艾滋病和CD4细胞计数<200/μL的中位时间分别为7.4年和6.9年。HIV阳性男性的死亡率为每1000患者年56.3例死亡，HIV阴性男性为每1000患者年6.1例死亡。我们的数据表明，泰国年轻男性感染HIV-1后进展为艾滋病和死亡的速度比发达国家类似年龄队列报告的要快。
