AIDS-RELATED CONDITIONS - STUDY OF A REPRESENTATIVE SAMPLE OF 1203 PATIENTS DECEASED IN 1992 IN FRANCE

Background. Little representative information exists on the frequency of human immunodeficiency virus (HIV)-related diseases among the overa ll AIDS population. The objective of this research is to assess the na ture, frequency and characteristics of these diseases among AIDS patie nts during their last year of life and to analyse these frequencies ac cording to the mode of transmission and other socio-demographic and me dical characteristics. Methods. To obtain comprehensive data, we condu cted an investigation based on retrospective collection of clinical in formation on a representative sample (1203 deaths) of all AIDS deaths that occurred in France during 1992. Results. The frequency of the dis eases was markedly higher than the one described in the AIDS surveilla nce registers and varied between homosexuals and intravenous drug user s (IVDU). After controlling for other variables (age, CD4 counts, surv ival times) by means of logistic regression, homosexuality remained a significant explaining factor for Kaposi's sarcoma, cytomegalovirus in fections, herpes simplex and cryptosporidiosis. In contrast, HIV encep halopathy, hepatitis, mental disorders, invasive candidiasis and cache xia were more frequent in male IVDU. Few differences were observed by sex. Conclusions. Several factors may explain the differences: variati on in exposure to infectious agents, general health status, use of med ical care and direct influence of the mode of HIV transmission. These data are of particular value for medical services in planning the magn itude of health care needs among the AIDS population overall, for clin icians and researchers for advancing the understanding of the natural history of AIDS and in the definition of prophylactic strategies again st opportunistic infections.