Follow-up at 4½ Years on Homosexual Men with Generalized Lymphadenopathy

Findings suggest that nitrate inhalants may act alone or in combination with other as yet unidentified cofactors after AIDS retrovirus-induced immunodeficiency by promoting the specific disease manifestation of Kaposis sarcoma.

Abstract

The authors report follow-up results from a longitudinal study of homosexual and bisexual men with persistent generalized lymphadenopathy initiated in 1981. At the 2 1/2-year follow-up 8 of the 42 men in the study had developed acquired immunodeficiency syndrome (AIDS). After 4 1/2 years 12 of the 42 patients (29%) had progression to AIDS including 7 with Kaposis sarcoma 2 with Pneumocystis carinii pneumonia 1 with both these conditions and 1 with non-Hodgkin lymphoma. The mean duration of lymphadenopathy before diagnosis of AIDS was 25 months. Observations in this series supports the possible role of cofactors in AIDS. Analysis at 2 1/2 years suggested that a history of heavy or moderate use of nitrate inhalant before study entry was predictive of ultimate progression to AIDS. The association between nitrate use and the development of Kaposis sarcoma remained significant at 4 1/2 years but no such association was observed for P. carinii pneumonia. Thus these findings suggest that nitrate inhalants may act alone or in combination with other as yet unidentified cofactors after AIDS retrovirus-induced immunodeficiency by promoting the specific disease manifestation of Kaposis sarcoma.