Denning P, Chu S, Hanson D, Ciesielski C; Interscience Conference on Antimicrobial Agents and Chemotherapy.

Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 1994 Oct 4-7; 114.

Centers for Disease Control and Prevention (CDC), Atlanta, GA.

Objective: To describe HIV wasting syndrome (WS) in adults/ adolescents with AIDS. Methods: Medical records from 19,951 HIV-infected persons greater than or equal to 13 years of age were reviewed every 6 months at health care facilities in 9 U.S. cities. The 1993 AIDS case definition was retrospectively applied to all persons under surveillance at these sites, and data on those who met the revised case definition between January 1, 1990 and August 31, 1992 were examined to determine the incidence and prevalence of WS and to characterize those persons with WS. Results: Of 7,805 persons with AIDS, 895 (11.5%) had WS; WS was the AIDS- indicator condition initially diagnosed in 322 (4.1%) persons and a subsequent diagnosis in 573 (7.3%). When AIDS- indicator conditions were ranked by order of frequency, WS followed CD4+ count less than 200 cells/microliter (87.2%), Pneumocystis carinii pneumonia (PCP) (31.7%), and esophageal candidiasis (13.3%). The prevalence of WS increased significantly as CD4+ count decreased (4% [CD4+ 100-199 cells/microliter]; 6.8% [CD4+ 50-99]; 7.5% [CD4+ 25-49]; and 12.5% [CD+ less than 25]; chi 2 = 92.7, p less than 10(-8)). Of the 3,795 persons surviving at least 1 year after AIDS diagnosis, 9.5% developed WS as a subsequent condition, and of the 1,435 surviving at least 2 years, 37.4% developed WS. Overall, persons with WS were significantly more likely to be aged 40 years or older (adjusted odds ratio [AOR] = 1.4, 95% CI = 1.1, 1.7), and significantly less likely to ever have received antiretroviral treatment (AOR = 0.7, 95% CI = 0.5, 0.9) or PCP prophylaxis/treatment (AOR = 0.6, 95% CI = 0.5, 0.8). Conclusions: WS was the third most common clinical condition, becoming more frequent as CD4+ counts declined. Certain AIDS treatments were associated with a decreased incidence of WS, but whether these findings reflect a therapeutic effect or improved health care needs to be explored. In addition, other preventive and nutritional interventions should be actively pursued to reduce morbidity due to WS.

Publication Types:

• Meeting Abstracts

Keywords:

• Acquired Immunodeficiency Syndrome
• Adolescent
• Adult
• CD4 Lymphocyte Count
• CD4-Positive T-Lymphocytes
• HIV Infections
• HIV Seropositivity
• HIV Wasting Syndrome
• Humans
• Incidence
• Pneumonia, Pneumocystis
• Prevalence
• United States
• Werner Syndrome

Other ID:

• 95920817

UI: 102213760

From Meeting Abstracts