AEGiS-13IAC: Progression to AIDS before and after the introduction of highly antiretroviral therapies according to different AIDS defining events in an Italian HIV prevalent cohort.

13th International AIDS Conference

Durban, South Africa - July 9-July 14, 2000

Progression to AIDS before and after the introduction of highly antiretroviral therapies according to different AIDS defining events in an Italian HIV prevalent cohort.

Int Conf AIDS 2000 Jul 9-14; 13:(abstract no. ThOrC743)

Porta D, Rapiti E, Forastiere F, Perucci CA
D. Porta, Via S. Costanza, 53, 00198 Rome, Italy, Tel.: +39 0651 686 470, Fax: +39 0651 686 463, E-mail: sida_oer@sirio.regione.lazio.it

BACKGROUND: After the introduction of the new highly antiretroviral therapies (HAART), differences in the rate of progression to AIDS according to the different AIDS defining event have been suggested. We analysed a HIV prevalent cohort of the Lazio Region in Italy to evaluate the extent of these differences.

METHODS: We examined 1561 persons with a prevalent HIV infection cohort enrolled in the Lazio Region (Italy) from 1988 to 1992. The date of seroconversion was estimated for each person using a multiple imputation on the basis of CD4%. We followed the cohort from the enrolment to the AIDS defining event, death or the end of follow-up (31 July 1998) taking into account the time from seroconversion. We divided the period of follow-up into three calendar periods (1988-1994, 1995-1996 and 1997-1998). We analysed each AIDS defining illness in separate Cox regression models treating the calendar period as a time-dependent variable and adjusting for age at seroconversion, sex, and modes of transmission.

RESULTS: We observed a significant decline in the risk of progression to AIDS for most of the AIDS defining events in the calendar period 1997-1998 compared with 1988-1994 (HR: 0.68, 95%CI: 0.11-0.66 for Candidiasis; HR:0.24, 95%CI:0.07-0.90 for Toxoplasmosis; HR:0.31, 95%CI:0.19-0.50 for all the opportunistic infections together). In the calendar period 1997-1998, no diagnoses of AIDS due to atypical Mycobacteria or to Kaposis Sarcoma were observed so that the the HRs for these AIDS defining illness in this period 1997-1998 approached zero. We observed an increased risk of developing AIDS in the period 1997-1998 for Tuberculosis (HR:3.73, 95%CI:1.09-12.8) and for Non-Hodgkins Lymphoma (NHL) (HR:3.34, 95%CI:0.32-35.1).

CONCLUSIONS: Our results confirm the general decrease of the incidence of AIDS defining events after the introduction of the HAART. However, the risk of developing Tuberculosis and NHL actually increased in the same period

Keywords: AEGIS, HIV, Acquired Immunodeficiency Syndrome, HIV Seropositivity, Antiretroviral Therapy, Highly Active, Incidence, Proportional Hazards Models, Anti-HIV Agents, HIV Wasting Syndrome, Tuberculosis, Drug Therapy, Combination, Italy, Epidemiology, therapy, drug therapy
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