RECENT INFECTION WITH HUMAN-IMMUNODEFICIENCY-VIRUS AND POSSIBLE RAPID LOSS OF CD4 T-LYMPHOCYTES

To assess a hypothesized trend that persons recently infected with the human immunodeficiency virus (HIV) may have more rapid declines in absolute CD4 T-lymphocyte (CD4(+) cell) counts than those who were HIV infected in earlier years, sequential CD4(+) cell counts in three groups who had definable dates of HIV seroconversion between 1978 and 1992 were reviewed. The CD4+ cell counts examined were from some of the longest extant studies in the United States. 100 homosexual and bisexual men engaged in ongoing observational cohort studies in San Francisco, Denver, and Chicago since 1978 (Group 1); 89 persons in South Carolina infected after 1986 (Group 2); and 155 injecting drug users participating in an observational cohort study in Baltimore since 1985 (Group 3). For all groups, individually and in the aggregate, mean CD4(+) cell counts declined rapidly in the first year after HIV infection and then stabilized. However, there was no clear trend for lower (or higher) CD4(+) cell counts by fixed time after HIV seroconversion among those seroconverting in recent compared with earlier calendar years. These data do no support a hypothesized trend for more rapid loss of CD4 T lymphocytes-and, by implication, more pathogenic strains of HIV-1-among persons acquiring HIV infection in recent years.