Predicting survival in AIDS : refining the model.
We tested the validity of a previously-published AIDS staging system by examining AIDS-defining diseases (ADDs) and CD4 counts as prognostic factors for survival of the 248 AIDS patients in the Edinburgh City Hospital Cohort, of whom 56% were injecting drug-users (IDUs).
Cox regression was used to model the proportionality of risk of death as the CD4 count declined and more ADDs were experienced, and dependence upon post-AIDS treatment.
Using the system of Mocroft et al. (Lancet 1995 ; 346 : 12-17) to grade severity, our data were well enough modelled, but we suggest :
(i) regrading of HIV dementia (RR 3.9,95% Cl 2.5-6.0), mainly attributed to the drug users, to a very severe ADD ;
(ii) reduction in risk from zidovudine (RR 0.7,95% Cl 0.5-1.0) during AIDS follow-up for patients starting treatment at or after AIDS diagnosis ;
(iii) improved management of first mild ADDs (from 1987-89 to 1994-95 : 40% reduction in IDUs appearing with mild index diseases, and an approximate three-fold reduction in risk associated with a mild ADD).
This study supports previous findings on the significance of ADDs and lowest CD4 count in predicting the lifetime of AIDS patients.
Mots-clés Pascal : SIDA, Virose, Infection, Facteur prédictif, Etude cohorte, Lymphocyte, Marqueur biologique, Diagnostic, Survie, Evaluation, Traitement, Homme, Grande Bretagne, Royaume Uni, Europe, Immunopathologie, Immunodéficit, Activité biologique, Organisation santé, Lymphocyte CD4
Mots-clés Pascal anglais : AIDS, Viral disease, Infection, Predictive factor, Cohort study, Lymphocyte, Biological marker, Diagnosis, Survival, Evaluation, Treatment, Human, Great Britain, United Kingdom, Europe, Immunopathology, Immune deficiency, Biological activity, Public health organization
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0549209
Code Inist : 002B06D01. Création : 24/03/1998.