AEGiS-14IAC: Marked improvment in survival following AIDS dementia in the era of highly active antiretroviral therapy.

14th International AIDS Conference


Barcelona, Spain - July 7-12, 2002

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Marked improvment in survival following AIDS dementia in the era of highly active antiretroviral therapy.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. ThOrC1446)

Dore GJ, McDonald A, Li Y, Kaldor J, Brew B
National Centre in HIV Epidemiology and Clinical Research, Sydney, Australia

BACKGROUND: The study aimed to determine the effect of introduction of highly active antiretroviral therapy (HAART) on survival following AIDS Dementia Complex (ADC).

METHODS: Australian AIDS notification data over the period 1993-2000 was examined. Analyses were based on all initial AIDS illnesses. In order to examine the impact of HAART, two periods of AIDS diagnosis were chosen: pre-HAART (1993-1995) and HAART (1996-2000). Median survival was based on Kaplan-Meier estimates, with examination of factors influencing survival in a Cox proportional hazards model.

RESULTS: Over the period 1993-2000 in Australia, 5017 initial AIDS illnesses were diagnosed among 4351 AIDS cases. The proportion of AIDS cases with ADC increased from 5.2% in 1993-1995 to 6.8% in 1996-2000 (p=0.029). Median survival following AIDS increased from 19.6 months for AIDS cases diagnosed in 1993-1995 to 39.6 months for AIDS cases diagnosed in 1996-2000 (p<0.0005). Median survival following ADC increased more than all other AIDS illnesses, from 11.1 month in 1993-1995 to 48.2 in 1996-2000 (p<0.0005). Most striking was the seven-fold increase in survival among ADC cases with a CD4 count <100mm3 at diagnosis; 5.1 months in 1993-1995 to 38.5 months in 1996-2000 (p<0.0005). In contrast to the marked improvement in ADC survival, median survival following other predominantly CNS AIDS illnesses (cryptococcosis plus toxoplasmosis) increased significantly, but only from 13.1 months to 25.5 months (p=0.013).

CONCLUSION: Although there has been a proportional increase in ADC at AIDS diagnosis, survival following ADC has improved markedly in the era of HAART. The relatively smaller and greater effects of HAART on ADC incidence and survival, respectively, when compared to other AIDS illnesses may increase the prevalence of ADC in many settings.

Keywords: AEGIS, Antiretroviral Therapy, Highly Active, AIDS Dementia Complex, Acquired Immunodeficiency Syndrome, CD4 Lymphocyte Count, Incidence, Proportional Hazards Models, Survival Analysis, Survival, Survival Rate, Australia, mortalityKWDaegis,antiretroviraltherapy,highlyactive,aidsdementiacomplex,acquiredimmunodeficiencysyndrome,cd4lymphocytecount,incidence,proportionalhazardsmodels,survivalanalysis,survival,survivalrate,australia,mortality

020707
ThOrC1446

Copyright © 2002 - International AIDS Society (IAS). Reproduction of this abstract (other than one copy for personal reference) must be cleared through the IAS.