Résumé :
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[BDSP. Notice produite par INIST N5cR0xrf. Diffusion soumise à autorisation]. The rate at which immunodeficiency develops in untreated human immunodeficiency virus type 1 (HIV-1) - infected persons might be increasing or decreasing over time because of viral evolution or other factors. Beginning in 1984, Multicenter AIDS Cohort Study investigators recruited HIV-1-seronegative homosexual/bisexual men from four US metropolitan areas and examined them semiannually for HIV-1 seroconversion. To assess possible secular changes in the natural history of HIV-1 infection, the authors examined CD4+lymphocyte data from 354 men who seroconverted between 1984 and 1991. To control for measurement differences among centers and over time, the authors adjusted CD4+lymphocyte values to those of persistently seronegative participants. CD4+lymphocyte percentage measurements at the first seropositive visit formed a U-shaped pattern, with the lowest values observed in 1988 and 1989. The authors observed no consistent secular pattern of CD4+percentages at later visit dates, except that mean CD4+percentages were consistently lowest in men who seroconverted in 1988. In a proportional hazards model, the time to the adjusted CD4+lymphocyte count of
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