CHANGING INCIDENCE OF AIDS-DEFINING ILLNESSES IN THE ERA OF ANTIRETROVIRAL COMBINATION THERAPY

Objective: To determine the incidence of AIDS-defining opportunistic i nfections and malignancies over a 5-year period from 1992 to 1996. Stu dy population: Subcohort of 1003 homosexual men with HIV infection and CD4 count less than 200 x 10(6) cells/l from the Frankfurt AIDS Cohor t Study. Methods: Data including the earliest date that a CD4 T-lympho cyte count < 200 x 10(6)/l was reached and the dates of AIDS-defining events were compiled from medical records. Incidence analyses for AIDS -defining events and death during the subsequent 5 years (1992-1996) w ere performed using rates per 100 person-years of exposure. Results: D uring the observation period, the number of patients per year with CD4 T-lymphocyte counts < 200 x 10(6)/l varied between 402 and 511. In 19 92, 56.7% of patients experienced at least one AIDS-defining illness, and 20.7% in 1996. The annual number of AIDS-defining events per 100 p atient-years of observation declined from 143.5 in 1992 to 38.3 in 199 6, and the number of AIDS-related deaths fell from 25.7 to 12.9. Analy sis of the number of events confirmed this trend for malignancies and single opportunistic infections, with the exception of mycobacterial d iseases. Conclusions: The incidence of AIDS-defining events in patient s with advanced HIV infection at Frankfurt University Hospital has dec lined by more than 70% from 1992 to 1996.