SURVIVAL AFTER AIDS DIAGNOSIS IN TUSCANY (ITALY), 1985-1992

The study evaluated the overall survival after AIDS diagnosis of 1,014 patients reported to the Italian AIDS Registry as resident in Tuscany , stratified by age, gender, year of diagnosis, HIV transmission categ ory, initial AIDS-defining disease and CD4(+) cells count. The study w as a population-based survival analysis, carried out through Kaplan-Me ier method (mean survival times - MST -, 1, 2 and 3-year observed surv ival) and Cox models (crude and adjusted relative risk - RR). The MST was 12.4 months for all cases, increasing from 4-7 months in 1985-1987 to 14 months in 1991-1992. The observed survival was 51.4% at the fir st year of follow-vp, 28.4% at the second year and 14.5% at the third year. The multivariate analysis showed an independent prognostic effec t of age, year of diagnosis, initial AIDS-defining disease and CD4(+) cells count. The prognosis was worse in cases aged over 44 (reference: 25-29), diagnosed before 1988 (reference: 1991) and with wasting synd rome, toxoplasmosis, HIV encephalopaty or multiple diseases (reference : PCP alone); and better in cases with more than 100 CD4(+) cells/mm(3 ) (reference: less than or equal to 50 cells/mm(3)). The differences i n gender and among HIV transmission categories disappeared after age-a djustment. The study confirmed, in an European population-based series , the poor long-term AIDS prognosis and, once AIDS has became clinical ly manifest, the prognostic value of some clinical and demographic var iables.