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  • Open Access

Is prognosis after first AIDS-defining pathology incidence becoming better in recent years of HAART era?

  • 1,
  • 1,
  • 2,
  • 3,
  • 4,
  • 5,
  • 6 and
  • 1
Journal of the International AIDS Society200811 (Suppl 1) :P251

https://doi.org/10.1186/1758-2652-11-S1-P251

  • Published:

Keywords

  • Pneumonia
  • Tuberculosis
  • Candidiasis
  • Community Hospital
  • Previous Period

Purpose of the study

To evaluate if prognosis of HIV infection, after the incidence of first AIDS-defining condition, is becoming better with improvement in HIV infection management protocols.

Methods

The COMESEM cohort registers any HIV-infected patient receiving care in any of a group of several general community hospitals responsible for global medical care to a population close to 1,600,000 inhabitants of Madrid's perimetropolitan area. In the actuality it registers 8,166 HIV-infected patients, with a follow-up of 42,148 patient-years. We included in the study any patient with a recent diagnosis of HIV infection (less than 6 months) who suffered a first AIDS-defining disease. Survival was measured with Kaplan-Meier test, and differences and hazard ratios between 4-yearly periods after 1996 (1996–1999, 2000–2003 and 2004–2008) were measured with Maentel-Haenzel's log-rank and Cox-regression tests.

Summary of results

3,987 patients included in the COMESEM cohort were recently diagnosed of HIV infection. 1,270 of them experienced first incidence of AIDS-defining condition, 603 after January 1, 1996. Most frequent diagnosed pathologies were tuberculosis (27.1%), P. jirovecii pneumonia (21.5%), and oro-oesophageal candidiasis (13.4%). Median survivals after first AIDS-defining condition in any of the evaluated periods in the HAART era were largely greater than 10 years, much longer than in the pre-HAART years (p < 0.0001). There were no significant differences in survival between 1996–1999 and 2000–2003 (p = 0.214). Nevertheless, survival was significantly better in period 2004–2008 vs. any of both previous periods 1996–1999 (HR = 2,905, 95% CI 1,620–5,208) or 2000–2003 (HR = 2,581, 95% CI 1,393–4,784). (Table 1.)

Table 1

  

Events

Events

Survival

Survival

Survival

Hazard Ratio

Hazard Ratio

Log-rank

Period

Patients

"n"

%

p-25%

median

p-75%

HR

IC.95%

"P"

1996–99

306

129

42,6

ND

ND

1,673

1

(reference category)

 

2000–03

191

53

27,7

ND

ND

2,669

1,230

0,887 – 1,706

=,214

2004–08

164

13

7,9

ND

ND

ND

2,905

1,620 – 5,208

<,0001

........

         

2000–03

191

53

27,7

ND

ND

2,669

1

(reference category)

 

2004–08

164

13

7,9

ND

ND

ND

2,581

1,393 – 5,208

=,001

.........

         

ND – not determinable (not afforded in the population studied).

Conclusion

Prognosis of HIV-infected patients after incidence of first AIDS-defining condition is becoming increasingly better in recent years, probably reflecting improvements in HIV infection treatment protocols.

Authors’ Affiliations

(1)
Hospital de Getafe, Getafe, Spain
(2)
Hospital de Móstoles, Móstoles, Spain
(3)
Hospital de Alcalá de Henares, Alcalá de Hnares, Spain
(4)
Hospital "Severo Ohoa", Leganés, Spain
(5)
Hospital "Fundación Alcorcón", Alcorcón, Spain
(6)
Hospital de Fuenlabrada, Fuenlabrada, Spain

Copyright

© Gaspar et al; licensee BioMed Central Ltd. 2008

This article is published under license to BioMed Central Ltd.

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