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American Journal of Epidemiology Vol. 130, No. 3: 530-539
Copyright © 1989 by The Johns Hopkins University School of Hygiene and Public Health

research-article

ACQUIRED IMMUNODEFICIENCY SYNDROME (AIDS)-FREE TIME AFTER HUMAN IMMUNODEFICIENCY VIRUS TYPE 1 (HIV-1) SEROCONVERSION IN HOMOSEXUAL MEN

ALVARO MUŅOZ1,, MEI-CHENG WANG1, SUE BASS1, JEREMY M. G. TAYLOR2, LAWRENCE A KINGSLEY3, JOAN S CHMIEL4, B. FRANK POLK1 6 and THE MULTICENTER AIDS COHORT STUDY GROUP 5

1Departments of Epidemiology and Biostatistics, The Johns Hopkins University School of Hygiene and Public Health Health, Baltimore, MD.
2Division of Biostatistics, UCLA School of Public Health LOB Angeles, CA.
3Departments of Infectious Diseases and Microbiology/ Epidemiology, Graduate School of Public Health, University of Pittsburgh Pittsburgh, PA.
4Cancer Center Biometry Section, Northwestern University Medical School Chicago, IL.

Reprint requests to Dr. Alvaro Muiņoz, Department of Epidemiology, The Johns Hopkins University School of Hygiene and Public Health. 615 N. Wolfe Street, Baltimore, MD 21205.

To estimate the time interval between human immunodeficiency virus type 1 (HIV-1) seroconversion and acquired immunodeficiency syndrome (AIDS) diagnosis in homosexual men, prospective incident cohorts are difficult to obtain and, if assembled, provide few events owing to the long incubation time. Although seroprevalent cohorts are numerous in size and events, the information is limlted due to the unknown times since seroconversion. To combine the information provided by 1,628 seroprevalent men (304 AlDS cases) and 233 seroconverters (12 AlDS cases) belng followed in a multicenter study since 1984, the postseroconversion changes in hematologk variables occurring in the incident cohort were used to develop a model thet allowed for the imputation of the unknown times since seroconversion for the seroprevalent cohort Nonparametric life table methods incorporating truncation and censoring were applied for the estimation of the probability distribution of the AIDS-free time after seroconversion. The precision of the estimates was evaluated using bootstrap methods. The analysis suggested that AlDS is unlikely (<O.5%) in the first year; 78% of seropositive homosexual men remain AIDS-free 60 months after seroconversion; and the AlDS incidence increases for months 12–36 and levels off at 38 per 1,000 personsemesters for months 42–60. The nonparametric estimate of the incidence rate suggests a median AIDS-free time of 11 years, which is longer than previous estimates based on parametric models

HIV seropositivity; incidence studies; probability; statistics; lymphocytes

1Dr. B. Frank Polk deceaeed This work stands as a tribute to his memory.

5Centers and inveatigatom. Baltimore—The Johns Hopkins University School of Hygiene and Public Health: B. F. Polk, H. Farmdegan, R Fox, J. Margolick, J. McArthur, A. Saah; Chicago—Howard Brown Memorial Clinic-Northwestern University Medical School: J. P. Phair, J. S. Chmiel, B. Cohen, K. Sheridan, S. Wolimky; Pittsburgh—University of Pittsburgh School of Public Health: C. R. Rinaldo, P. Gupta, M. Ho, L. A. Kingsley, R. 0. Valdiserri, A. Winkelstein; Los Angeles—University of California Schools of Public Health and Medicine: R. Detels, B. R. Visacher, A. Couhn, J. Dudley, J. L. Fahey, J. V. Giorgi, D. Imagawa, J. Taylor; Data Coordinating Center—The Johns Hopkins University School of Hygiene and Public Health: A. Muiioz, S. Baas, V. Carey, L. P. Jacobson, K. Y. Liang, S. Su, M. C. Wang, S. L. Zeger; National Institutes of Health—National Institute of Allergy and Lnfectioua Diseases: P. Fleming, W. C. Blackwelder, R. A. Kaslow, M. J. vanRaden; National Cancer Institute: I. Obrams.


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