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PubMed · 9474349

Predicting survival in AIDS: refining the model.

S J Hutchinson·R P Brettle·S M Gore
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Abstract

We tested the validity of a previously-published AIDS staging system by examining AIDS-defining diseases (ADDs) and CD4 counts as prognostic factors for survival of the 248 AIDS patients in the Edinburgh City Hospital Cohort, of whom 56% were injecting drug-users (IDUs). Cox regression was used to model the proportionality of risk of death as the CD4 count declined and more ADDs were experienced, and dependence upon post-AIDS treatment. Using the system of Mocroft et al. (Lancet 1995; 346:12-17) to grade severity, our data were well enough modelled, but we suggest: (i) regrading of HIV dementia (RR 3.9, 95% CI 2.5-6.0), mainly attributed to the drug users, to a very severe ADD; (ii) reduction in risk from zidovudine (RR 0.7, 95% CI 0.5-1.0) during AIDS follow-up for patients starting treatment at or after AIDS diagnosis; (iii) improved management of first mild ADDs (from 1987-89 to 1994-95: 40% reduction in IDUs appearing with mild index diseases, and an approximate three-fold reduction in risk associated with a mild ADD). This study supports previous findings on the significance of ADDs and lowest CD4 count in predicting the lifetime of AIDS patients.

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AIDS Dementia ComplexAcquired Immunodeficiency SyndromeAdultAnti-HIV AgentsCD4 Lymphocyte CountCohort StudiesFemaleHumansLymphoma, AIDS-RelatedMaleMiddle AgedModels, StatisticalPneumonia, PneumocystisPrognosisRisk FactorsSubstance Abuse, IntravenousSurvival AnalysisZidovudineJournal Article

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S J Hutchinson, R P Brettle, S M Gore. 1997. Predicting survival in AIDS: refining the model.. https://doi.org/10.1093/qjmed%2F90.11.685

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