SURVIVAL DIFFERENCES IN EUROPEAN PATIENTS WITH AIDS, 1979-89

Objectives-To examine the pattern of survival and factors associated w ith the outcome of disease in patients with AIDS. Design-Inception coh ort. Data collected retrospectively from patients' charts.Setting-52 c linical centres in 17 European countries. Subjects-6578 adults diagnos ed with AIDS from 1 January 1979 to 31 December 1989. Main outcome mea sures-Survival after the time of diagnosis. Results-The median surviva l after diagnosis was 17 months, with an estimated survival at three y ears of 16% (95% confidence interval 15% to 17%). Patients diagnosed i n southern Europe had a shorter survival, particularly immediately aft er the time of diagnosis, compared with patients diagnosed in central and northern Europe (survival at one year (95% confidence interval) 54 % (52% to 56%) 66% (64% to 68%), 65% (63% to 66%), respectively. The t hree year survival, however, was similar for all regions. The regional differences in survival were less pronounced for patients diagnosed i n 1989 compared with earlier years. Improved survival in recent years was observed for patients with a variety of manifestations used to def ine AIDS but was significant only for patients diagnosed with Pneumocy stis carinii pneumonia. The three S ear survival, however, remains unc hanged over time. Conclusions-Survival of AIDS patients seems to vary within Europe, being shorter in southern than central and northern Eur ope. The magnitude of these differences, however, has declined gradual ly over time. Short term survival has improved in recent years, but th e long term prognosis has remained equally poor, reflecting the fact t hat the underlying infection with HIV and many of the complicating dis eases remains essentially uncontrolled.