Marked improvement in survival following AIDS dementia complex in the era of highly active antiretroviral therapy.

Abstract

OBJECTIVE:

To determine the effect of introduction of highly active antiretroviral therapy (HAART) on survival following AIDS dementia complex (ADC).

METHODS:

Australian AIDS notification data in the period 1993-2000 were examined. In order to examine the impact of HAART, two periods of AIDS diagnoses were chosen: pre-HAART (1993-1995) and HAART (1996-2000). Median survival was based on Kaplan-Meier estimates, with examination of factors influencing survival in a Cox proportional hazards model.

RESULTS:

In the period 1993-2000 in Australia, 5017 initial AIDS illnesses were diagnosed among 4351 AIDS patients. The proportion of AIDS cases with ADC increased from 5.2% in 1993-1995 to 6.8% in 1996-2000 (P = 0.029). Median survival following AIDS increased from 19.6 months for those diagnosed with AIDS in 1993-1995 to 39.6 months for those diagnosed in 1996-2000 (P < 0.0005). Median survival following ADC increased to a greater extent than that for all other AIDS illnesses, from 11.9 months in 1993-1995 to 48.2 in 1996-2000 (P < 0.0005). Most striking was the increase in survival among those with ADC and a CD4 cell count < 100 x 10(6) cells/l at diagnosis; 5.1 months in 1993-1995 to 38.5 months in 1996-2000 (P < 0.0005).

CONCLUSION:

Although there has been a proportional increase in ADC at AIDS diagnosis, survival following ADC has improved markedly in the era of HAART.

• Authors: Gregory J Dore, Ann McDonald, Yueming Li, John M Kaldor, Bruce J Brew, National HIV Surveillance Committee
• Journal: AIDS (London, England) (AIDS) Vol. 17 Issue 10 Pg. 1539-45 (Jul 04 2003) ISSN: 0269-9370 [Print] England
• PMID: 12824792 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-HIV Agents

Topics

• AIDS Dementia Complex (epidemiology, immunology, mortality)
• Acquired Immunodeficiency Syndrome (epidemiology)
• Adult
• Aged
• Anti-HIV Agents (therapeutic use)
• Antiretroviral Therapy, Highly Active
• Australia (epidemiology)
• CD4 Lymphocyte Count
• Female
• Humans
• Incidence
• Male
• Middle Aged
• Population Surveillance
• Proportional Hazards Models
• Survival Rate