The natural history of human immunodeficiency virus infection in screened HIV positive U.S. Air Force personnel: a preliminary report.

We prospectively studied 157 HIV antibody-positive U.S. Air Force personnel identified by universal ELISA screening and confirmed by Western blot. They were initially evaluated and then re-evaluated at least once at approximately 1 year intervals. In order to determine which if any demographic and serologic cofactors were significantly related to progression of immunodeficiency early in the course of disease, we compared these variables with the mean change in CD4 cells per month and with progression in Walter Reed stage. Upon entry into the study, the subjects were classified as follows: sex: 153 (97.5%) male, 4 (2.5%) female; race: 84 (53.5%) white, 63 (40.1%) black, 8 (5.1%) Hispanic, and 2 (1.3%) Oriental; age: mean of 28.6 years (63.0% between 20 and 32 years); and Walter Reed stage: 108 (68.8%) Walter Reed 1, 26 (16.6%) Walter Reed 2, 9 (5.7%) Walter Reed 3, 6 (3.8%) Walter Reed 4, 5 (3.2%) Walter Reed 5, and 3 (1.9%) Walter Reed 6. The mean follow-up period was 12.2 months (range of 2 to 35 months). The mean change in CD4 cells per month was -0.072 (range of -94.75 to +67.58). Factors at entry that are significantly related to loss of CD4 cells included serum IgA over 300 mg/dl (p = 0.0450) and anergy (p = 0.0093). Factors at entry significantly related to progression in Walter Reed stage included serum IgA over 300 mg/dl (p = 0.0001), low absolute CD4 count (p = 0.0001), and low CD4/CD8 ratio (p = 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)