Nonprogressors of HIV infection: Hong Kong experience

Objectives: The progression of human immunodeficiency virus (HIV) disease varies considerably among infected people, being affected by factors such as virus characteristics, host response, and their interactions. Some patients with HIV may remain clinically and immunologically well for an extended period. This study aims to describe the frequency and demographic features of a group of HIV-1 positive nonprogressors in Hong Kong. Method: A retrospective study was conducted of records of a cohort of 58 HIV-1 positive patients infected for over 7 years in Hong Kong. Nonprogression is defined as the maintenance of health with no symptoms and a CD4 level of 500/μL or higher. Results: Twenty-five patients had progressed to acquired immunodeficiency syndrome (22 died); 3 had had other HIV-related symptoms; 22 were asymptomatic but had CD4 lower than 500/μL; and 8 (13.8%) were nonprogressors with no symptoms and CD4 count higher than 500/μL (median of 665/μL an average of 102.5 months after HIV detection). The nonprogressors had a relatively high CD8 level. Hemophilia with transfusion of HIV-contaminated blood products accounted for 100% of all nonprogressors, and 58% of those with clinical or immunologic progression (P = 0.041). Conclusion: These findings indicate that a proportion of HIV-infected individuals do not progress clinically or immunologically over a prolonged period. To date, all nonprogressors known to the authors are patients with hemophilia.