title: Natural history of human immunodeficiency virus disease in southern India.
abstract: There are few reports of the natural history of human immunodeficiency virus (HIV) infection from Asia. In a retrospective analysis of 594 patients (72.9% male; baseline CD4 cell count, 216 cells/microL) receiving care at YRG Center for AIDS Research and Education, a tertiary HIV referral center in southern India, the mean duration of survival from serodiagnosis was 92 months. Ninety-three percent of the patients acquired infection through heterosexual contact. The most common acquired immune deficiency syndrome-defining illnesses were pulmonary tuberculosis (49%; median duration of survival, 45 months), Pneumocystis carinii pneumonia (6%; median duration of survival, 24 months), cryptococcal meningitis (5%; median duration of survival, 22 months), and central nervous system toxoplasmosis (3%; median duration of survival, 28 months). Persons with a CD4 lymphocyte count of <200 cells/microL were 19 times (95% confidence interval [CI], 5.56-64.77) more likely to die than were those with CD4 cell count of >350 cells/microL. Patients who had > or =1 opportunistic infection were 2.6 times more likely to die (95% CI, 0.95-7.09) than were those who did not have an opportunistic infection. Antiretroviral therapy for patients with low CD4 lymphocyte counts improved the odds of survival (odds ratio, 5.37; 95% CI, 1.82-15.83).
authors.affiliation: Y. R. Gaitonde Center for AIDS Research and Education, Dr.ALM Post Graduate Institute of Basic Medical Sciences, University of Madras, Chennai-600017 India. nkumarasamy@eth.net
authors.forename: N
authors.initials: N
authors.lastname: Kumarasamy
authors.forename: Suniti
authors.initials: S
authors.lastname: Solomon
authors.forename: Timothy P
authors.initials: TP
authors.lastname: Flanigan
authors.forename: R
authors.initials: R
authors.lastname: Hemalatha
authors.forename: S P
authors.initials: SP
authors.lastname: Thyagarajan
authors.forename: Kenneth H
authors.initials: KH
authors.lastname: Mayer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000401:mortality / Q000503:physiopathology* / Q000821:virology; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015996:Survival Rate