Mortality and survival trends in patients with AIDS in north east England from 1984-1992.
OBJECTIVE
to study trends in mortality and survival in patients with AIDS attending an ID unit.


METHODS
retrospective analysis of patients developing an AIDS-defining illness between April 1984, and November 1992. Survival was analysed by calculation of survival product-limit.


RESULTS
71 patients were analysed (including four women), 23 of whom are still alive. Pneumocystis carinii pneumonia (PCP) was the most frequent AIDS-index diagnosis: n = 36 (51%); 24 of these patients have died. HIV encephalopathy was the most frequent diagnosis at death; n = 16 (22.5%), followed by mycobacterial infection; n = 11 (15.5%), and PCP and CMV infection, each occurring in 10 (14%). One-, 2- and 3-year survival probabilities for patients with AIDS before 1987 were 0.46, 0.15 and 0 compared with probabilities of 0.63, 0.5 and 0.3 in those diagnosed after 1987; log rank -P < 0.01. One- and 2-year survival probabilities in patients who received at least 3 months' zidovudine (AZT) therapy were 0.76 and 0.53 in those who are still alive compared with 0.55 and 0.33 in the deceased, while values for deceased AZT-naive patients were 0.29 and 0.1; -P < 0.01. Thirteen (27%) deaths occurred within 2 months of an AIDS-index disease. In 10 patients this was their first presentation to the department. PCP accounted for 8 (61%) of these deaths.


CONCLUSIONS
survival in patients with AIDS has increased since 1987, when AZT was introduced. Early AIDS-related deaths are frequent in patients who have had no prior medical care. This has implications for education and provision of care in individuals with asymptomatic HIV infection.
Dorrell
L
L
Infectious Diseases Unit, Newcastle General Hospital, Newcastle Upon Tyne, U.K.
Snow
M H
MH
Ong
E L
EL
D015526:AIDS Dementia Complex / Q000175:diagnosis / Q000401:mortality; D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis / Q000401:mortality; D000163:Acquired Immunodeficiency Syndrome / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality*; D000328:Adult; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D011020:Pneumonia, Pneumocystis / Q000150:complications / Q000175:diagnosis / Q000401:mortality; D011336:Probability; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D015215:Zidovudine / Q000627:therapeutic use
D015215:Zidovudine