Document 2678
 DOCN  M94A2678
 TI    HIV-1 syncytium-inducing phenotype does not predict AIDS in a cohort of
       injecting drug users in contrast with findings in homosexual men.
 DT    9412
 AU    Spijkerman IJ; Koot M; Prins M; Mientjes GH; van den Hoek JA; Miedema F;
       Coutinho RA; Municipal Health Service, Amsterdam, The Netherlands.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(1):25 (abstract no. 075C). Unique
       Identifier : AIDSLINE ICA10/94369897
 AB    OBJECTIVE: The prognostic value of syncytium-inducing (SI) phenotype of
       the human immunodeficiency virus type 1 (HIV-1) has mainly been studied
       in homosexual men. We studied the prevalence, incidence and prognostic
       value for progression to AIDS of the HIV-1 SI phenotype in a group of
       HIV-1 infected injecting drug users (IDU). METHODS: A prospective study
       of HIV-1 infected IDU without AIDS (n = 192) was carried out during a
       4.5-year follow-up period. Every 4 months the participants were tested
       for the presence of SI variants and studied for progression to AIDS (CDC
       '87). SI variants were detected by cocultivation of peripheral blood
       mononuclear cells with the MT-2 T-cell line. RESULTS: SI-variants were
       detected in 6 out of 192 participants at the beginning of the study
       period (3.1%), and 16 participants switched from NSI to SI variants
       (cumulative incidence after 4 years 13.7%, 95% CI 8.4-22 12.1). Of the
       192 IDU, 24 progressed to AIDS. Of 12 AIDS cases the viral phenotype was
       known at the time of AIDS diagnosis; 2 AIDS cases had the SI phenotype
       (17%) and 10 cases the NSI phenotype. In the remaining 12 AIDS cases NSI
       variants were present at the last visit before AIDS was diagnosed (in 8
       cases within 0.5 year before AIDS). Cox proportional Hazard analysis
       showed that the SI phenotype did not predict AIDS while low CD4+ cell
       count at baseline did. The switch from NSI to SI phenotype (n = 16)
       occurred at a mean CD4+ cell count of 0.32 * 10(9)/L (95% CI 0.23-0.41).
       DISCUSSION: A comparative study in our cohort of homosexual men (n =
       225) has shown that the prevalence and incidence of SI phenotype is
       higher among homosexual men. The most important difference, however, was
       that the NSI/SI switch among IDU occurred at a lower CD4 level (0.32
       compared to 0.48 (95% CI 0.42-0.54)). Furthermore 56% of the AIDS cases
       among homosexual men had the SI phenotype compared to only 17% among
       drug users at the time of AIDS diagnosis. In multivariate Cox
       proportional hazard analysis the SI phenotype was an independent
       predictor of AIDS among homosexual men but not in drug users.
 DE    Acquired Immunodeficiency Syndrome/EPIDEMIOLOGY/*MICROBIOLOGY  Cohort
       Studies  Comparative Study  Homosexuality  Human  HIV-1/*GENETICS
       Incidence  Male  Netherlands/EPIDEMIOLOGY  Phenotype  Predictive Value
       of Tests  Prevalence  Proportional Hazards Models  Prospective Studies
       *Substance Abuse, Intravenous  MEETING ABSTRACT

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