Impact of protease inhibitors and other antiretroviral treatments on acquired immunodeficiency syndrome survival in San Francisco, California, 1987-1996
Sk. Schwarcz et al., Impact of protease inhibitors and other antiretroviral treatments on acquired immunodeficiency syndrome survival in San Francisco, California, 1987-1996, AM J EPIDEM, 152(2), 2000, pp. 178-185
Citations number
69
Categorie Soggetti
Envirnomentale Medicine & Public Health","Medical Research General Topics
The authors assessed temporal trends in acquired immunodeficiency syndrome
(AIDS) survival for 15,271 persons in San Francisco, California, diagnosed
between 1987 and 1996 with an opportunistic illness included in the 1987 AI
DS case definition. Predictors of survival were evaluated for 5,686 persons
who were diagnosed between 1993 and 1996 and met the 1993 AIDS case defini
tion. Median survival was 19 months for persons diagnosed between 1987 and
1989, 17 months for persons diagnosed between 1990 and 1992, 15 months for
persons diagnosed between 1993 and 1994, and 31 months for persons diagnose
d between 1995 and 1996. Decreased mortality was associated with use of ant
iretroviral therapy without protease inhibitors before AIDS (relative hazar
d (RH) = 0.88, 95% confidence interval (CI): 0.8, 1.0) and after AIDS (RH =
0.83, 95% CI: 0.7, 0.9) and use of antiretroviral agents with protease inh
ibitors before AIDS (RH = 0.25, 95% CI: 0.2, 0.3) and after AIDS (RH = 0.36
, 95% CI: 0.3, 0.4). Increased mortality was found for persons aged greater
than or equal to 40 years (RH = 1.43, 95% CI: 1.3, 1.6), persons initially
diagnosed with an opportunistic illness (RH = 1.97, 95% CI: 1.8, 2.2), and
homosexual injection drug users (RH = 1.33, 95% CI: 1.2, 1.5). Survival af
ter AIDS has increased. Treatment with antiretroviral agents, particularly
protease inhibitors, strongly predicts improved survival.