HIV disease progression in Australia in the time of combination antiretroviral therapies.
OBJECTIVE
To examine the effect of recent developments in antiretroviral therapy on HIV disease progression and survival.


METHODS
Retrospective cohort study.


METHODS
Two cohorts of people with HIV were defined retrospectively from the records of a large immunology laboratory. The first cohort were subjects whose CD4+ T cell counts had dropped to 200 x 10(6)/L during 1990, and the second were subjects whose CD4+ T cell counts had dropped to 200 x 10(6)/L in 1994.


METHODS
HIV disease progression and survival was determined over a minimum three years of follow-up for each cohort (i.e., 1990-1993; 1994-1997).


RESULTS
346 subjects were included in the analysis (193 subjects from 1990 and 153 from 1994). The relative risk of progression to AIDS in the 1994 cohort compared with the 1990 cohort was 0.57 (95% confidence interval, 0.35-0.91; P = 0.018) and the relative risk of death was 0.20 (95% confidence interval, 0.08-0.49; P < 0.001).


CONCLUSIONS
There were 43% fewer AIDS cases and 80% fewer deaths in the time following the increased availability of combination antiretroviral therapy in Australia.
Correll
P K
PK
National Centre in HIV Epidemiology and Clinical Research, Sydney, NSW. pcorrell@nchecr.unsw.edu.au
Law
M G
MG
McDonald
A M
AM
Cooper
D A
DA
Kaldor
J M
JM
D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage* / Q000009:adverse effects; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D018450:Disease Progression; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
D019380:Anti-HIV Agents