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Information on HIV progression
Dec 19, 1996

I'm interested in information on HIV progression. I've heard two scenarios: 1. Once infected HIV, it may take 8-15 years before tcell counts drop to 200 or below. -OR- 2. Once infected with HIV there is a rapid progression to tcell counts of 200 or lower (within a year or so). Are these scenarios correct, or are they just stereotypical? What is the probability that HIV could progress to tcell counts below 200 in four or five years instead of ten or one? I'd be interested in any medical references you could provide. Thanks

Response from Dr. Cohen

Both scenarios can be true. The average time from seroconversion to AIDS (as defined clinically, not by CD4 count) is about 10 years. However, that number comes from studies that were carried out before we began treating people early with highly effective therapy. Also, that number is just an average, though, so progression can occur much more rapidly or much more slowly in individual patients.

With respect to your last question, I can tell you that in the San Francisco cohort, the proportion of people who had progressed from seroconversion to an AIDS-defining illness (not CD4 under 200), was zero by one year, 3% by three years, 12% by five years, 36% by eight years, 53% by 10 years, and 68% by 14 years. Again, that study was carried out before the advent of highly effective therapy.

Am I unusual? Treatment recommendations?
Final stage

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