Important note: Information in this article was accurate in 1990. The state of the art may have changed since the publication date.
NATURAL HISTORY OF HUMAN IMMUNODEFICIENCY VIRUS INFECTION AND KEY PREDICTORS OF HIV DISEASE PROGRESSION
AIDS Clinical Review 1989. Volberding P and Jacobson MA, eds. New York, Marcel Dekker, p. 69-93, 1989.. Unique Identifier : AIDSLINE ICDB/90659411 Hessol NA; Lifson AR; Rutherford GW; AIDS Office, San Francisco Dept. of Public Health, San Francisco,; CA
Abstract:
Although tremendous strides have been made in understanding the natural history of HIV infection and predictors of disease progression, there are still many scientific issues that need better resolution. The epidemiology and natural history studies of HIV infection in homosexual and bisexual men, iv drug users, and blood and blood product recipients are examined. Answers to the following questions are discussed: (1) Is the incubation period between infection and diagnosis with AIDS the same in all transmission risk groups? (2) How can laboratory or clinical predictors of disease progression be used to treat and counsel people who are infected but have not developed AIDS? (3) Are there any proven cofactors for disease progression that can be avoided through behavior modification? (4) Will all those infected with HIV eventually develop AIDS? (5) What effect will antiviral therapies and vaccines have on the natural history of HIV infection? Seroconversion to HIV infection does not occur simultaneously in all transmission groups. Understanding of subclinical and clinical markers of disease progression is still in the developmental stage, and it is not clear how to interpret them on an individual basis in terms of treatment or counseling. Individuals infected with HIV have been advised to modify certain behaviors (ie, eliminate exposure to other viruses, maintain good nutrition, rest, take certain vitamins, avoid drugs and alcohol) to reduce the risk of disease progression, but the only cofactor consistently associated with disease progression is duration of infection. It is still not possible to say whether everyone infected with HIV will develop AIDS; however, several mathematical models predict 100% development over many years of infection and without treatment. Ultimately, antiviral therapy and possibly vaccines may significantly alter the natural history of HIV infection. Until then, education and risk reduction are the primary public health weapons for combating this epidemic. (139 Refs)
Keywords: Acquired Immunodeficiency Syndrome/MICROBIOLOGY Bisexuality Blood Transfusion Cross-Sectional Studies Female Homosexuality Human HIV/*PATHOGENICITY HIV Infections/DIAGNOSIS/EPIDEMIOLOGY/*MICROBIOLOGY/TRANSMISSION Incidence Infant, Newborn Male Maternal-Fetal Exchange Pregnancy Risk Factors Substance Abuse, Intravenous/COMPLICATIONS Virus Activation MONOGRAPH REVIEW REVIEW, TUTORIAL 900430
M9040676
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Important note: Information in this article was accurate in 1990. The state of the art may have changed since the publication date.
