The role of initial AIDS-defining illness in survival following AIDS.

Important note: Information in this article was accurate in 1995. The state of the art may have changed since the publication date.

The role of initial AIDS-defining illness in survival following AIDS.

Annu Conf Australas Soc HIV Med. 1994 Nov 3-6;6:108 (unnumbered abstract). Unique Identifier : AIDSLINE ASHM6/95291718
Luo K; Law M; Kaldor JM; McDonald AM; Cooper DA; National Centre in HIV Epidemiology and Clinical Research,; Sydney.

Abstract: OBJECTIVE: To examine the role of initial AIDS-defining illness and trends over time in survival following AIDS. METHODS: Survival was calculated for all adult and adolescent AIDS cases (N = 3204) in Australia diagnosed through 1 November 1991 and reported to the National AIDS Registry by 31 March 1994. The Cox regression method was used to identify independent predictors of survival. RESULTS: Age under 50, a CD4+ cell count > 100 cells/microliter and an initial diagnosis of Kaposi's sarcoma were independently associated with longer survival (P < 0.05), while acquisition of HIV infection through blood transfusion and non-Hodgkin's lymphoma as an initial AIDS-defining illness were significantly associated with shorter survival (P < 0.05). Survival improved substantially from 1986 to 1987, but did not improve further thereafter. A further study of initial AIDS-defining illness in a subgroup of cases, namely men aged less than 50 years at diagnosis who acquired HIV infection through homosexual or bisexual contact and were diagnosed after 1987, showed that Kaposi's sarcoma, Pneumocystis carinii pneumonia, oesophageal candidiasis and herpes simplex virus as initial AIDS-defining illnesses had a relatively better prognosis than other single illnesses, independently of the CD4+ cell count at AIDS diagnosis. Furthermore, cases with multiple illnesses did not have a worse prognosis than cases with a single illness, provided all the illnesses were in the better prognosis category. CONCLUSIONS: Initial AIDS-defining illness, as well as HIV exposure, age, year and CD4+ cell count at AIDS diagnosis, plays an important role in survival following AIDS in Australia.

Keywords: Acquired Immunodeficiency Syndrome/DIAGNOSIS/*MORTALITY/ TRANSMISSION Adolescence Adult AIDS-Related Opportunistic Infections/DIAGNOSIS/MORTALITY Cause of Death Female Follow-Up Studies Human Lymphoma, AIDS-Related/DIAGNOSIS/MORTALITY Male Middle Age New South Wales/EPIDEMIOLOGY *Population Surveillance Sarcoma, Kaposi's/DIAGNOSIS/MORTALITY Survival Rate ABSTRACT
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