title: Marked improvement in survival following AIDS dementia complex in the era of highly active antiretroviral therapy.
abstract: OBJECTIVE
  To determine the effect of introduction of highly active antiretroviral therapy (HAART) on survival following AIDS dementia complex (ADC).
  
  
  METHODS
  Australian AIDS notification data in the period 1993-2000 were examined. In order to examine the impact of HAART, two periods of AIDS diagnoses were chosen: pre-HAART (1993-1995) and HAART (1996-2000). Median survival was based on Kaplan-Meier estimates, with examination of factors influencing survival in a Cox proportional hazards model.
  
  
  RESULTS
  In the period 1993-2000 in Australia, 5017 initial AIDS illnesses were diagnosed among 4351 AIDS patients. The proportion of AIDS cases with ADC increased from 5.2% in 1993-1995 to 6.8% in 1996-2000 (P = 0.029). Median survival following AIDS increased from 19.6 months for those diagnosed with AIDS in 1993-1995 to 39.6 months for those diagnosed in 1996-2000 (P < 0.0005). Median survival following ADC increased to a greater extent than that for all other AIDS illnesses, from 11.9 months in 1993-1995 to 48.2 in 1996-2000 (P < 0.0005). Most striking was the increase in survival among those with ADC and a CD4 cell count < 100 x 10(6) cells/l at diagnosis; 5.1 months in 1993-1995 to 38.5 months in 1996-2000 (P < 0.0005).
  
  
  CONCLUSIONS
  Although there has been a proportional increase in ADC at AIDS diagnosis, survival following ADC has improved markedly in the era of HAART.
authors.affiliation: National Centre in HIV Epidemiology and Clinical Research, The University of New South Wales, Sydney, Australia.
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: Dore
authors.forename: Ann
authors.initials: A
authors.lastname: McDonald
authors.forename: Yueming
authors.initials: Y
authors.lastname: Li
authors.forename: John M
authors.initials: JM
authors.lastname: Kaldor
authors.forename: Bruce J
authors.initials: BJ
authors.lastname: Brew
mesh_terms: D015526:AIDS Dementia Complex / Q000453:epidemiology / Q000276:immunology / Q000401:mortality*; D000163:Acquired Immunodeficiency Syndrome / Q000453:epidemiology; D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D001315:Australia / Q000453:epidemiology; D018791:CD4 Lymphocyte Count; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D016016:Proportional Hazards Models; D015996:Survival Rate
chemical_list: D019380:Anti-HIV Agents