Incubation time of acute human immunodeficiency virus (HIV) infection and duration of acute HIV infection are independent prognostic factors of progression to AIDS

The severity and the duration of acute human immunodeficiency virus (HIV) i nfection (AHI) are associated with a faster rate of progression to AIDS, bu t the prognostic value of the length of incubation time of AHI (IncAHI), de fined as the time between HIV infection and AHI, on progression to AIDS has not been assessed. We explored this issue prospectively in 70 individuals with documented AHI and a known date of HIV infection. The median IncAHI wa s 21.5 days (range, 5-70 days), and the median duration of AHI was 15.5 day s (range, 3-67 days). The adjusted relative hazard of progression to AIDS o r to a CD4(+) count <200 X 10(3)/mL was 4.23 (95% confidence interval [CI], 1.40-12.73; P = .01) for the patients with an IncAHI <21.5 days, compared with those with longer IncAHI, and was 3.53 (95% CI, 1.09-11.36; P = .03) f or the patients with a duration of AHI >15.5 days, compared with those with shorter duration. Both IncAHI and duration of AHI were independent predict ors of progression. This suggests that early pathogenic events before the o nset of AHI influence the rate of HIV disease progression.