[sci.med.aids] Time to illness

liz@ai.mit.edu (Liz A. Highleyman) (01/16/91)

I was under the impression that the time between infection with HIV and
the development of illness was somewhere in the area of 5 years.  Yet
I have also heard that people who received transfusions of infected
blood (early in the epidemic) were known to get sick within a few months.
How can this be?  Is it taking longer and longer for people to develop
OIs?  Does this indicate that HIV is perhaps becoming less virulent?

-Liz

winters@pdn.paradyne.com (John Winters) (01/16/91)

If you get blood from an AIDS patient, you are getting many more of
the virus than the one or two you would get otherwise.  Of course, this
puts you into a more advanced condition at the onset.  That is why it does
not need to take as long.

rob@mtdiablo.Concord.CA.US (Rob Bernardo) (01/17/91)

In article <1991Jan15.174741.14099@cs.ucla.edu> liz@ai.mit.edu (Liz A. Highleyman) writes:
>I was under the impression that the time between infection with HIV and
>the development of illness was somewhere in the area of 5 years.

A significant number of people have been infected but not ill for 10 years.

>  Yet
>I have also heard that people who received transfusions of infected
>blood (early in the epidemic) were known to get sick within a few months.
>How can this be?

They got a relatively large "dose" of the virus?

>  Is it taking longer and longer for people to develop
>OIs?

Improved treatments is probably a huge factor here.

>  Does this indicate that HIV is perhaps becoming less virulent?

There is evidence that differing strains have differing virulence.
(This is a big reason why people who are already infected should
engage in safe sex even with each other:  to protect
against getting infected by a more virulent strain of HIV.)
-- 
Rob Bernardo					Mt. Diablo Software Solutions
email: rob@mtdiablo.Concord.CA.US		phone: (415) 827-4301

dgreen@uunet.UU.NET (01/17/91)

liz@ai.mit.edu (Liz A. Highleyman) writes:
|> I was under the impression that the time between infection with HIV and
|> the development of illness was somewhere in the area of 5 years.  Yet
|> I have also heard that people who received transfusions of infected
|> blood (early in the epidemic) were known to get sick within a few months.
|> How can this be?  Is it taking longer and longer for people to develop
|> OIs?  Does this indicate that HIV is perhaps becoming less virulent?

I had the opportunity to interact with a mathematical epidemiologist
this summer: she estimated the time from exposure to full-blown AIDS has
a standard half-life of about 8-10 years.  This means that at 8 years, 
half of the people exposed will have contracted full-blown AIDS.  At 16 
years, 3/4 will have contracted full-blown AIDS, etc.

I know of no documentation indicating that HIV is becoming less virulent.
It makes sense that a person who received a massive infusion of infected
blood might take less time to contract the full disease, than one who
was exposed through some other, less efficient transmission mode.
Furthermore, in the beginning years of the epidemic, no testing was done
of donated blood, so the likelihood of getting a transfusion containing
a raging infection might be higher.

Finally, however, it is a good rule of thumb that over many years, fatal
infectious agents evolve to something less virulent:  from an 
evolutionary standpoint, it isn't good policy to kill one's host.  
However, the number of years required to see this evolution will likely 
be large, especially in the case of HIV, which already takes a very long
time to kill the host.

____
\  /Dan Greening	IBM T.J.Watson Research Center	 NY (914) 784-7861
 \/ dgreen@ibm.com	Yorktown Heights, NY 10598-0704	 CA (213) 825-2266

aberno@questor.wimsey.bc.ca (Anthony Berno) (01/20/91)

liz@ai.mit.edu (Liz A. Highleyman) writes:

> I was under the impression that the time between infection with HIV and
> the development of illness was somewhere in the area of 5 years.  Yet
> I have also heard that people who received transfusions of infected
> blood (early in the epidemic) were known to get sick within a few months.
> How can this be?  Is it taking longer and longer for people to develop
> OIs?  Does this indicate that HIV is perhaps becoming less virulent?
> 
> -Liz

Actually, the time from infection to the onset of noticeable symptoms 
averages almost 8-10 years! I read a number of articles on the
subject that discussed the onset time of the disease - for a person
infected "today", symptoms will take an average of about 10 years to
appear. The typical scenario is that nothing happens for two years, then
T-cell counts drop from their normal 1000 by about 100  per year. When the
counts hit about 200, you start to get sick.

Curiously, there is a little statistical anomaly in that the average person
developing AIDS today was infected only 6-7 years ago. This is due to the
skewed profile of the epidemic (well, ALL epidemics are like that...) i.e.
most people infected with HIV were infected recently, so that those
that deveop the disease early are disproportionatly represented.

Keep in mind that HIV is not a carefully timed clock - as always, some
people will develop the disease immediately, others will take many many 
years. I have heard of no difference correlated with the mode of infection,
but then I have been a little out of touch.

Sorry, I can never remember my sources for my statistics. I think the 
above ones were from a March issue of Science?