Survival and progression of HIV disease in women attending GUM/HIV clinics in Britain and Ireland. Study Group for the MRC Collaborative Study of HIV Infection in Women.
OBJECTIVE
To describe the pattern of clinical disease in women with HIV infection and to examine the effect of potential cofactors, including oral contraceptive use, alcohol and smoking, ethnic group, and route of HIV transmission, on progression to AIDS and death.


METHODS
Prospective observational cohort study.


METHODS
15 HIV and genitourinary medicine (GUM) clinics in Britain and Ireland.


METHODS
505 women aged over 18 years with a positive HIV antibody test entered the study between June 1992 and August 1995, with outcome data available for 503 women, and 1208 woman years of follow up to April 1996.


METHODS
AIDS defining conditions, incidence of AIDS, and death.


RESULTS
120 women (24%) had AIDS at entry to the study. There were 99 incident AIDS cases and 132 deaths during 1208 woman years of follow up. Pneumocystis carinii pneumonia (PCP) was the commonest first AIDS defining condition in white women (31% of AIDS cases), followed by oesophageal candidiasis (19%) while tuberculosis was the most common first AIDS defining condition among black African women (24% of AIDS cases), followed by oesophageal candidiasis (19%). In multivariate analyses, rate of progression to AIDS was significantly related to CD4 lymphocyte count at entry and PCP prophylaxis, but not to ethnic group, route of HIV transmission, alcohol, smoking, or oral contraceptive use. Mortality from all causes was not significantly different in women infected through injecting drugs (adjusted ratio 1.1, 95% confidence interval 0.7-1.8) compared with those infected through sexual intercourse, and non-significantly lower in black African women (0.7, 0.3-1.2) compared with white women. Survival was not significantly related to smoking, alcohol, or oral contraceptive use.


CONCLUSIONS
In women attending GUM/HIV clinics, the pattern of AIDS defining conditions differs by ethnic group, but progression of HIV disease is not importantly related to smoking, alcohol, oral contraceptive use, route of HIV transmission, or ethnic group.
D017088:AIDS-Related Opportunistic Infections / Q000276:immunology / Q000401:mortality; D000328:Adult; D000349:Africa / Q000208:ethnology; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D015658:HIV Infections / Q000208:ethnology / Q000276:immunology / Q000401:mortality*; D006801:Humans; D015994:Incidence; D007494:Ireland / Q000453:epidemiology; D015999:Multivariate Analysis; D011379:Prognosis; D015819:Substance Abuse, Intravenous / Q000150:complications; D015996:Survival Rate; D006113:United Kingdom / Q000453:epidemiology