Natural history of advanced HIV disease in patients treated with zidovudane
| Autor: | Terri Creagh-kirk, Douglas D. Richman, Richard E. Chaisson, Richard D. Moore, Jeanne C. Keruly |
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| Rok vydání: | 1992 |
| Předmět: |
Sexually transmitted disease
medicine.medical_specialty medicine.diagnostic_test business.industry Opportunistic infection Lymphocyte Immunology AIDS-related complex Hematocrit medicine.disease Surgery Zidovudine Infectious Diseases medicine.anatomical_structure Acquired immunodeficiency syndrome (AIDS) Internal medicine medicine Immunology and Allergy Prospective cohort study business medicine.drug |
| Zdroj: | Aids. 6:671-678 |
| ISSN: | 0269-9370 |
| DOI: | 10.1097/00002030-199207000-00009 |
| Popis: | Objective To describe the natural history of advanced HIV disease in patients treated with zidovudine. Design Longitudinal, observational study. Setting Twelve academic and community-based sites. Patients, participants Eight hundred and sixty-three patients with AIDS or AIDS-related complex (ARC) with a CD4+ lymphocyte count less than 250 x 10(6)/l, who first received zidovudine between 15 April 1987 and 14 April 1988. Main outcome measures Survival, progression to AIDS and first development of specific opportunistic illness. Results Median survival after initiation of zidovudine therapy ranged from greater than 900 days in patients with a baseline CD4+ lymphocyte count greater than or equal to 150 x 10(6)/l to 560 days in patients with a CD4+ lymphocyte count less than 50 x 10(6)/1. Other factors associated significantly with poorer survival were diagnosis of AIDS (versus ARC), baseline age greater than or equal to 40 years, hematocrit less than 35%, and diminished functional status. In patients with ARC at enrollment, median time of progression to AIDS ranged from 810 days in patients with a CD4+ lymphocyte count greater than or equal to 150 x 10(6)/l to 310 days in patients with a CD4+ lymphocyte count less than 50 x 10(6)/l. Rates of development of specific opportunistic infections or neoplasms and HIV encephalopathy were determined for different baseline CD4+ lymphocyte count ranges. Myelosuppression was significantly more common in patients with CD4+ lymphocyte counts greater than or equal to 100 x 10(6)/l. Sixty-five per cent of patients with a CD4+ lymphocyte count greater than or equal to 100 x 10(6)/l and 51% with a CD4+ lymphocyte count less than 100 x 10(6)/l continued to receive zidovudine 2 years after starting therapy. Conclusions We describe the natural history of a cohort of patients treated with zidovudine for advanced HIV disease. These CD4+ lymphocyte count-stratified estimates of disease progression should provide prognostic information useful in the clinical management of advanced disease and the design of future studies. |
| Databáze: | OpenAIRE |
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