EFFECT OF SEX, AGE AND TRANSMISSION CATEGORY ON THE PROGRESSION TO AIDS AND SURVIVAL OF ZIDOVUDINE-TREATED SYMPTOMATIC PATIENTS

Objective: To evaluate the effect of transmission category and demogra phic, clinical and immunological characteristics on the progression to AIDS and survival of zidovudine-treated patients. Design: Prospective multicentre cohort study of symptomatic non-AIDS patients.Setting: Ei ghty-three clinical centres reporting data to the National Zidovudine Registry. Patients: A total of 1468 patients enrolled between July 198 7 and January 1991 were analysed. Main outcome measures: Three-year AI DS-free survival probability estimates since therapy start. Cox propor tional hazards regression analysis was used to identify independent pr edictors of progression to AIDS and survival. Results: Faster progress ion was associated with increasing age (8% risk increase for a 5-year increase), low baseline CD4+ count (39% risk increase for 100x10(6)/I cells decrease), and zidovudine >1000 mg/day (20% risk increase compar ed with less than or equal to 1000 mg/day). Homosexual men had a 33% r isk increase compared with other risk groups. The presence of fever an d oral candidiasis at enrolment were also independently associated wit h a higher risk of progression. Differences in the risk of progression were not significant between men and women. Older age, baseline CD4count, homosexual behaviour, fever and oral candidiasis were independe ntly associated with a shorter survival. Conclusions: Our results conf irm that age and baseline CD4+ count are independent predictors of pro gression, but do not provide evidence for differences in clinical outc ome between the sexes. The higher risk of progression to AIDS and shor ter survival for homosexual men appears to be correlated with the high er risk of developing Kaposi's sarcoma.