Important note: Information in this article was accurate in 1992. The state of the art may have changed since the publication date.
Gender differences in the spectrum of HIV disease. ARCA Spectrum of Disease Working Group.
Int Conf AIDS. 1992 Jul 19-24;8(1):Mo10 (abstract no. MoC 0032). Unique Identifier : AIDSLINE ICA8/92399987 Creagh T; Thompson M; Morris A; Whyte B; AIDS Research Consortium of Atlanta, Inc., Georgia.
Abstract:
OBJECTIVE: To determine gender differences in the spectrum of HIV disease in adults. METHODS: All HIV-infected adults (greater than 13 yrs) entering the office or clinic of a participating site between February 1, 1990 and December 1, 1990 were eligible for enrollment. Thirty-two private practitioners (Internal Medicine, Family Practice and Infectious Disease) have participated. Medical records are abstracted onto a standard data collection form by trained personnel. Data are collected for a 12 month interval prior to enrollment and 6 month intervals after enrollment. Patients are followed until death or loss-to followup. Data collected include demographic information, transmission mode, CDC-defined AIDS diseases/conditions, other infections and conditions, treatments, and laboratory results. The study and analyses are ongoing. RESULTS: A total of 2,606 men and 252 women were enrolled. Median follow-up time was similar for women and men (24 months for both). Mean age of women was 32.9 years compared to 35.3 years for men (p = .002). Mean CD4 lymphocyte count at baseline was 356 for women and 274 for men (p = .0001). After enrollment, women who were diagnosed with AIDS during follow-up were diagnosed significantly later (8.2 months versus 6.9 months) than men, as would be predicted from baseline CD4 counts. Analyses of risk for development of specific opportunistic infections showed no gender differences, when stratified by baseline CD4 counts. Overall estimates of survival according to gender showed no significant differences. However, when the cohort was stratified according to baseline CD4 counts, women with less than 100 CD4 cells survived a significantly shorter time than men (median survival 25 months versus 29 months, p less than .01). DISCUSSION: Some studies have indicated that the course of HIV disease in women may lead to earlier mortality than is seen in men. In assessing survival by gender, it will be important to determine whether stage of disease is comparable. In our cohort, a survival analysis which controlled for baseline CD4 counts showed that women in later stages of HIV infection have more rapid disease progression than men. CONCLUSION: Women with HIV infection may have a poorer prognosis than men at comparable baseline CD4 counts.
Keywords: Adolescence Adult Cohort Studies Comparative Study CD4-Positive T-Lymphocytes Female Human HIV Infections/COMPLICATIONS/*EPIDEMIOLOGY Leukocyte Count Male Middle Age Opportunistic Infections/COMPLICATIONS/*EPIDEMIOLOGY Prospective Studies Risk Survival Analysis ABSTRACT 921230
M92C5360
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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.
