AIDS SURVIVAL AND PROGRESSION IN BLACK-AFRICANS LIVING IN SOUTH LONDON, 1986-1994

Objectives: To describe the rate of progression to AIDS and survival f ollowing AIDS diagnosis in HIV-infected Africans living in London. To identify factors influencing progression and outcome of disease. Desig n: Retrospectively constructed prevalent cohort. Setting: Outpatient c linic population, London. Subjects: HIV-infected individuals of Africa n origin presenting between January 1986 and October 1994. Main outcom e measures: AIDS indicator illness; cumulative survival probabilities to AIDS diagnosis and from AIDS diagnosis to death; rate of progressio n to AIDS. Results: Ninety six patients (57 women) provided 166 person years of follow up. Median CD4 lymphocyte count at presentation was 2 05 (90% range 20-577) x 10(6)/l. Kaplan-Meier estimates of the proport ion (95% confidence interval) of patients developing AIDS from the tim e of enrolment were 18 (9 to 27)% at 12 months and 44 (30 to 58)% at 3 6 months. Only CD4 count at HIV diagnosis was independently associated with a faster rate of progression to AIDS (adjusted relative hazard 9 .18, 95% confidence interval 2.84 to 29.67, p < 0.001). The proportion (95% confidence interval) surviving following AIDS diagnosis was esti mated to be 73 (55 to 91)% at 12 months and 25 (0 to 52)% at 36 months . Conclusions: HIV-infected people of sub-Saharan African origin livin g in London present with advanced disease. When compared with publishe d studies, their survival experience is comparable to that observed in HIV-infected individuals born in developed countries.