REASONS GIVEN BY PATIENTS FOR NON-PROGRESSION IN HIV-INFECTION

Identification of the reasons for long-term survival in HIV infection is an area of current intense research. The objective of this study wa s to determine the perceptions among patients with different rates of disease progression as to the reasons for a good outcome with HIV. In a case-central study of 134 long-term (greater than or equal to 8 year s) HIV-infected participants, 62 were defined as non-progressors: curr ent CD4 cell count greater than or equal to 500 x 10(6)/L and asymptom atic or only mildly symptomatic. Two groups of control patients were i dentified: intermediate progressors who also had been HIV-infected for greater than or equal to 8 years, but whose current CD4 cell count wa s < 500 x 10(6)/L (n = 61), and a group of rapid progressors who had d eveloped AIDS within 5 years of HIV infection (n = 11). Non-progressor s were asked 'what do you feel are the reasons for your good outcome w ith HIV-infection?' and intermediate and rapid progressors were asked 'what do you feel are the reasons for a good outcome with HIV infectio n?'. Mental attitude, and in particular a positive outlook was the rea son most frequently given for a good outcome among both nonprogressors (NP) 42%, and progressors (P) 40%, followed by lifestyle measures and personal action (NP 31%, P 35%). Medical treatments such as anti-retr oviral drugs were rarely suggested (< 3%). No significant differences were observed in the frequency of the different reasons given by non-p rogressors and progressors. The belief among our long-term HIV-infecte d individuals, that a positive outlook, lifestyle and personal action are important determinants of a good prognosis, is in sharp contrast t o the biomedical model of disease progression that prevails among the medical and scientific research community.