Dore G, Li Y, Cooper D, Kaldor J; Australasian Society for HIV Medicine. Conference.
Annu Conf Australas Soc HIV Med. 1996 Nov 14-17; 8: 86 (abstract no. 89).
National Centre in HIV Epidemiology and Clinical Research, Darlinghurst, NSW.
AIM: To examine trends over time in level of immunodeficiency at diagnosis of HIV-related opportunistic infections and malignancies. STUDY POPULATION: A retrospective cohort of 1390 people with AIDS seen at St. Vincent's Hospital HIV medicine unit between 1983-1994. METHODS: Date of all AIDS illness and CD4 count within three months of diagnosis were collected. Three sub-cohorts based on interval of AIDS diagnosis were defined: 1983-1987, 1988-1990, 1991-1994. Trends in median CD4 count for individual AIDS illnesses over time were examined by logistic regression. RESULTS: The median CD4 count of each opportunistic infection and malignancy was less than 50/mm3. The only AIDS illness with 10% or more episodes presenting at a CD4 count greater than 200/mm3 were extra-pulmonary tuberculosis (10.0%), progressive multifocal leukoencephalopathy (10.7%), and non-Hodgkin's lymphoma (12.7%). Kaposi's sarcoma was the only AIDS illness for which there was a significant decline in median CD4 count at diagnosis over time (40/mm3 in 1983-1987 to 15/mm3 in 1991-1994; p = 0.04). Median CD4 count at diagnosis of each opportunistic infection was stable over time. The median CD4 count at AIDS diagnosis was lower among cases receiving Pneumocystis carinii pneumonia (PCP) prophylaxis prior to AIDS (23/mm3 vs 42/mm3; p<0.0005), and cases with antiretroviral therapy exposure prior to AIDS (28/mm3 vs 42/mm3; P<0.0005). CONCLUSION: Although antiretroviral therapy and prophylaxis against PCP appear to delay onset of AIDS, the level of immunodeficiency at which individual opportunistic infections sent has not changed.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- CD4 Lymphocyte Count
- HIV Infections
- HIV Seropositivity
- Opportunistic Infections
- Pneumonia, Pneumocystis
- Sarcoma, Kaposi
- diagnosis
Other ID:
UI: 102221924
From Meeting Abstracts