CLINICAL, EPIDEMIOLOGIC AND NATURAL-HISTORY STUDY OF HIV-1 INFECTION AMONG SEROPOSITIVE HOMOSEXUALS BISEXUALS IN ISRAEL, 1986-92 - A COLLABORATIVE STUDY IN 3 MEDICAL-CENTERS

The clinical and epidemiological aspects of HIV-1 seropositive homo/bi sexuals at three AIDS screening clinics in Israel were analyzed retros pectively for the 4-year period 1986-92. Of 1,526 individuals who atte nded the clinics a total of 238 (15.5%) were found to be HIV-1 seropos itive; 182 seropositives were followed for a mean of 3.3 (+/-2.6) pers on-years. The incidence of AIDS in this cohort was 33% over 4 years, a rate of 9.8/100 person-years. Half of all HIV-1 seropositives are est imated to have been infected outside Israel. On initial presentation 1 44 (62%) were asymptomatic and 94 (38%) were symptomatic. CD4 levels w ere >500 ml3 in 87 (36%), 200-500 ml3 in 66 (28%) and <200 ml3 in 45 ( 19%) individuals. The pattern of clinical presentations was similar to that seen in the West, but mycobacterial infections were rare. A coho rt of 86 homo/bisexuals with full-blown AIDS was followed for a mean o f 2.2 person-years. The mortality rate in this group was 53.5% over 4 years, a rate of 26/100 person-years. Thus, HIV infection among Israel i homosexuals ceased to be a rarity as it took the pattern of AIDS in the West, with some special features such as the late presentation of patients for medical treatment and the paucity of mycobacterial diseas es complicating the disease.