Natural History of HTLV III Infection in USAF Personnel: Clinical Evaluation, Laboratory Evaluation, Assessment of In Vivo and In Vitro Immunologic Status, and Data Storage

Abstract : The Wilford Hall USAF Medical Center HIV Scientific Group has continued to enroll new HIV positive patients and during the period of this report has reached accumulative number of 989 patients in the databank. Over the past 6 months, we have performed 236 evaluations including 59 new patients and 177 reevaluations. During the time period of this report, the US Air Force HIV Natural History Study was continued with a significant number of individuals returning for their evaluation. Rates of progression continued to be low in Walter Reed stage 1 and 2 and much higher in Walter Reed stage 4 and 5. A subgroup of 26 rapid progressors was compared to a controlled population of 26 non progressors and analyzed for surrogate markers of disease progression. Absolute CD4A cell count and serum IgA were the 2 strongest predictors of progression prospectively. Opportunistic infections were monitored and over 100 were diagnosed. The majority of these, approximately 60%, were Pneumocytis carinii pneumonia. Opportunistic infections were almost never seen when the CD4A helper cell count was greater than or equal to 200. During the period of this report, routine treatment of individuals with CD4A helper cells of below 200 per cubic millimeter with AZT and anti PCP prophylaxis were initiated.