Prognostic factors of survival of HIV-infected patients with cytomegalovirus disease: Aquitaine Cohort, 1986-1997. Groupe d'Epidémiologie Clinique du SIDA en Aquitaine (GECSA).
OBJECTIVE
To analyse survival of HIV-infected patients who developed cytomegalovirus (CMV) disease and to identify prognostic factors of their survival.


METHODS
Cases of CMV disease diagnosed in the Aquitaine Cohort of HIV-infected patients (n = 4297) during the 1986-1996 period, were reviewed using standardised definitions. Follow-up was extended to December 1997. Cox model was used to determine factors associated with survival after the initial manifestations of CMV disease, considering protease inhibitor (PI) prescription and anti-CMV treatment as time dependent covariates.


RESULTS
253 patients presented a CMV disease of which 221 (87.3%) died (median survival: 7 months). A better prognosis for survival was associated with: PI prescription [relative hazard (RH): 0.26; 95% confidence interval (CI): 0.11-0.59], anti-CMV treatment (RH: 0.37; CI: 0.25-0.54), CD4+ lymphocyte cell count > 50/mm3 (RH: 0.66; CI: 0.47-0.94) and absence of neoplasia (RH: 0.70; CI: 0.52-0.94) whereas the disseminated CMV disease worsened prognosis (RH: 1.83; CI: 1.20-2.80).


CONCLUSIONS
Antiretroviral treatment including PI, improved short-term prognosis of CMV disease regardless of its clinical manifestations.
Binquet
C
C
Unité INSERM 330, Université Victor Segalen Bordeaux 2, France.
Saillour
F
F
Bernard
N
N
Rougier
M B
MB
Leger
F
F
Bonnal
F
F
Dabis
F
F
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy / Q000401:mortality*; D000328:Adult; D015331:Cohort Studies; D003586:Cytomegalovirus Infections / Q000188:drug therapy / Q000401:mortality*; D017726:Cytomegalovirus Retinitis / Q000188:drug therapy / Q000401:mortality; D003627:Data Interpretation, Statistical; D005260:Female; D005500:Follow-Up Studies; D005602:France; D017320:HIV Protease Inhibitors / Q000627:therapeutic use; D006467:Hemophilia A / Q000150:complications; D020010:Heterosexuality; D006716:Homosexuality; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D011379:Prognosis; D016016:Proportional Hazards Models; D015819:Substance Abuse, Intravenous / Q000150:complications; D016019:Survival Analysis; D013997:Time Factors
D017320:HIV Protease Inhibitors