Gender-specific differences in the natural history, clinical features, andsocioeconomic status of HIV-infected patients: Experience of a treatment centre in Vienna

Background: in order to evaluate natural history, clinical features, and so cioeconomic aspects in HIV-infected women, a prospective study comprising 6 95 HIV-infected patients was performed at our department. Methods: Demographic data, CD4+ T-lymphocyte counts, human immunodeficiency virus-1 (HIV-1) plasma loads, AIDS indicator diseases and socioeconomic va riables were recorded. Prognostic factors for survival were evaluated by un ivariate and multivariate analysis. Data of men and women were compared. Results: The mean age of the 150 women (29.4 +/- 9.4 years) was significant ly lower than that of men (32.6 +/- 9.7 years, p = 0.0002). CD4+ T-lymphocy te counts, HIV1- plasma loads, and AIDS indicator diseases did not signific antly differ between men and women; the same was true for all socioeconomic variables (family status, education, professional training, employment sta tus) except family status. No significant difference in median overall and AIDS-free survival was obse rved between females (2033 and 1593 days) and males (1554.5 and 1235 days, respectively p = 0.36 and p = 0.098). Overall survival compared by age groups (< 30, 31-50, > 50 years), by risk categories (homosexuals, iv drug users, heterosexual contacts) and by CD4T-lymphocyte count (<200, 200-500, >500 cells/mm(3)), differed significantl y (p < 0.001) as did AIDS-free survival. Lower age and a high CD4+ T-lymphocyte count were independently associated with the outcome in the multivariate analysis. (Overall survival/relative r isk: 0.49 for age < 30 years and 2.3 for CD4+ T-lymphocyte count < 200 cell s/mm(3), AIDS-free survival/relative risk:0.65 for age < 30 years and 3.3 f or CD4+ T-lymphocyte count < 200 cells/mm3). HIV-1 plasma loads as a progno stic factor could not be evaluated due to the small number of patients who died or developed AIDS (2/375 and 10/375 patients, respectively). Conclusion. Our results showed no difference in the natural history and cli nical features of HIV infection between men and women. However, pulmonary t uberculosis was associated with a significantly longer survival compared to other AIDS-defining diseases. Lower age and high CD4+ T-lymphocyte count are independent predictors for s urvival. With the exception of family status, socioeconomic variables showe d no differences between male and female patients.