Combination therapy for HIV : the effect on inpatient activity, morbidity and mortality of a cohort of patients.
We set out to quantify the changes in HIV-related morbidity and mortality associated with the clinical use of antiretroviral therapy via prospectively collected patient-related events (admissions, bed days, deaths, WHO stage 3 and 4 events and drug costs) on all HIV patients known to the Regional Infectious Disease Unit (RIDU) from 1 January 1987 to 31 December 1996.
The introduction of zidovudine monotherapy in 1987 for those with AIDS was associated with a subsequent decline of inpatient activity for 2 years : in 1989 there was a 23% reduction in bed days but only a 6% reduction in admissions.
A further dramatic decline of patient-related events in those with AIDS was noted during 1996 following the introduction of combination therapy, a 39% reduction in admissions, 44% reduction in bed days, 54% reduction in stage 4 events, 33% reduction in WHO stage 3 events and 40% reduction in the death rate.
Reductions were also observed for patients without AIDS including a 42% reduction in the rate of patients developing AIDS.
Similar reductions were noted when the patients were classified by immunological instead of clinical status although data for 1997 suggest an increase in patient-related activity for those with CD4 counts>200 cells/ul possibly as a result of low levels of anti-HIV therapy.
The introduction of combination therapy for HIV has to date led to a minimum saving of one inpatient bed per 100 patient years which helped defray the cost of combination therapy. (...)
Mots-clés Pascal : SIDA, Virose, Infection, Antiviral, Association médicamenteuse, Zidovudine, Hospitalisation, Morbidité, Mortalité, Coût, Chimiothérapie, Traitement, Epidémiologie, Homme, Pronostic, Pyrimidine nucléoside, Didésoxynucléoside, Immunopathologie, Immunodéficit, Economie santé
Mots-clés Pascal anglais : AIDS, Viral disease, Infection, Antiviral, Drug combination, Zidovudine, Hospitalization, Morbidity, Mortality, Costs, Chemotherapy, Treatment, Epidemiology, Human, Prognosis, Pyrimidine nucleoside, Dideoxynucleoside, Immunopathology, Immune deficiency, Health economy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0127152
Code Inist : 002B05C02D. Création : 22/06/1998.