Important note: Information in this article was accurate in 1992. The state of the art may have changed since the publication date.
Progression of HIV infection among homosexual men in HBV vaccine cohorts in Amsterdam (AM), New York City (NY) and San Francisco (SF), 1978-1991.
Int Conf AIDS. 1992 Jul 19-24;8(1):Mo17 (abstract no. MoC 0065). Unique Identifier : AIDSLINE ICA8/92400019 van Griensven GJ; Hessol NA; Koblin BA; Stevens CE; Katz MH; Coutinho RA; Municipal Health Service, AM.
Abstract:
OBJECTIVE: To study progression of HIV infection from date of HIV seroconversion to AIDS and death in order to evaluate the impact of socio-demographic variables and the use of zidovudine (AZT) and Pneumocystis carinii pneumonia (PCP) prophylaxis (PCPP). METHODS: Participants were homosexual men with well documented dates of HIV seroconversion who participated in hepatitis B vaccine trials in AM (n = 84), NY (n = 121) and SF (n = 168). Progression of HIV infection was evaluated using Kaplan-Meier and Cox proportional hazard analysis. Variables included in the analysis were age, race, study site, AZT and PCPP use and presenting AIDS diagnosis. RESULTS: Of the 373 men, 35 were diagnosed with AIDS in AM, 51 in NY and 75 in SF. By the end of 1991, 18 of these men had died in AM, 33 in NY and 52 in SF. The median time from seroconversion to AIDS was 10.5 years; from AIDS to death 1.9 years and from seroconversion to death 12.2 years. Significantly fewer men presented with KS in AM than in NY or SF. AIDS cases in AM were more likely to occur after 1986 and were less likely to have used AZT or PCPP. Among the three cohorts combined, younger age and receiving treatment with AZT and PCPP were significantly related to a longer survival from seroconversion to AIDS and from seroconversion to death. No differences were found in survival by city. However, after adjusting for year of AIDS diagnosis, AIDS presenting diagnosis, use of AZT and PCPP, AIDS cases in NY and SF had a significantly shorter survival from AIDS diagnosis to death than those in AM. CONCLUSIONS: There were distinct geographical differences in the proportion of men with KS as presenting AIDS diagnosis. The smaller proportion of men in AM having used AZT and PCPP suggests a reservation towards therapy in AM compared to the American cities. Differences in survival time from seroconversion to AIDS and from seroconversion to death suggest a longer survival among those younger and among those receiving treatment with AZT and PCPP. Since this study is not a clinical trial this finding needs to be interpreted with caution.
Keywords: Acquired Immunodeficiency Syndrome/EPIDEMIOLOGY Age Factors Cohort Studies Comparative Study Hepatitis B/PREVENTION & CONTROL Homosexuality Human HIV Infections/COMPLICATIONS/DRUG THERAPY/*EPIDEMIOLOGY Life Tables Male Netherlands/EPIDEMIOLOGY New York City/EPIDEMIOLOGY Pneumonia, Pneumocystis carinii/EPIDEMIOLOGY/ETIOLOGY/PREVENTION & CONTROL Proportional Hazards Models San Francisco/EPIDEMIOLOGY Sarcoma, Kaposi's/EPIDEMIOLOGY/ETIOLOGY Survival Analysis Viral Hepatitis Vaccines Zidovudine/THERAPEUTIC USE ABSTRACT 921230
M92C5328
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Important note: Information in this article was accurate in 1992. The state of the art may have changed since the publication date.
