SURVIVAL AND MORTALITY PATTERNS OF AN ACQUIRED-IMMUNODEFICIENCY-SYNDROME (AIDS) COHORT IN NEW-YORK-STATE

The survival experience and causes of death of acquired immunodeficien cy syndrome (AIDS) patients were studied using a cohort of 3,699 AIDS patients in New York State, excluding New York City, whose illness was diagnosed before January 1990 at age 13 years or older. The median le ngth of survival for all cases was 11 .5 months, and survival increase d over time from 5.3 months pre-1 984 to 9.3 months in 1984-1986 and t o 13.2 months in 1987-1989. In a Cox proportional hazards model, risk of dying was higher for persons aged 35 years or more at diagnosis and for persons with a diagnosis other than Pneumocystis carinii pneumoni a or Kaposi's sarcoma whose illness was diagnosed before 1986. In this AIDS cohort, 2,834 (77 percent) persons died before 1991; 87 percent of the death certificates listed human immunodeficiency virus (HIV)/AI DS or an AIDS indicator disease as one of the multiple causes of death . The finding that 13 percent of the death certificates did not mentio n AIDS/HIV suggests that use of death certificates alone to count HIV- related deaths would result in an undercount. The recent expansion of the federal AIDS case definition is expected to add HIV-infected perso ns who die from conditions, such as recurrent pneumonia, that were not included in the earlier definition.