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8th Annual Conference Of The British HIV Association [BHIVA]19 – 21 April 2002, University of York, York |
[AUTHOR(S):] K Bhaskaran on behalf of CASCADE collaboration
MRC Clinical Trials Unit, London, UK
BHIVA Conf 2002 Apr 19-21;8:O2
OBJECTIVES: To investigate changes in survival following HIV seroconversion (SC) and factors associated with survival in three calendar periods.
METHODS: We analysed CASCADE data pooled from 20 SC cohorts in Europe and Australia, using Cox models allowing for late entry. We estimated the effect of calendar year on survival, adjusting for age at SC; exposure category; sex; presentation during acute infection and stratified by cohort. These cofactors were then further investigated in each of three calendar periods (to 1996, 1997–1998, 1999–2001).
RESULTS: Of 7154 seroconverters, 1880 (26%) died. Compared with pre-1997, the relative risk (95% confidence interval [CI]) of death fell to 0.42 (0.35–0.51), 0.29 (0.23–0.36), 0.19 (0.15–0.25) and 0.21 (0.14- 0.31) in 1997, 1998, 1999 and 2000/2001 respectively. Compared with those aged 16–24 years at SC, the relative risk of death (95% CI) for persons aged 45 or more fell to 1.37 (0.56–3.34) in 1999-2001 compared with 3.00 (2.45–3.67) in the period before 1997. Despite no apparent difference in survival by exposure category in the period before 1997, injecting drug users (IDUs) appeared to have a higher risk of death in 1997-1998 and 2000–2001 compared with those exposed through sex between men (relative risk and 95% CI= 2.27, 1.64–3.15 and 3.27, 2.03–5.27 respectively).
CONCLUSIONS: The initial increase in survival expectations has continued. However, IDUs appear to have worse survival in later calendar periods compared to other exposure groups. Age at SC seems to have less prognostic importance in more recent periods.
PRESENTING AUTHOR: K Bhaskaran
020419
O2
Copyright © 2002 - British HIV Association (BHIVA) Reproduction of this abstract (other than one copy for personal reference) must be cleared through the BHIVA Organising Secretariat 1 Mountview Court, 310 Friern Barnet Lane, London N20 0LD