Dworkin M S, Wan P C, Hanson D L, Jones J L
Division of HIV/AIDS Prevention, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
J Infect Dis. 1999 Sep;180(3):621-5. doi: 10.1086/314937.
To examine factors affecting survival after diagnosis of progressive multifocal leukoencephalopathy (PML), we analyzed data from an observational cohort study, the Adult and Adolescent Spectrum of HIV Disease project. We identified 415 patients diagnosed with PML during 1990-1997. The median survival time after diagnosis was 1 month. By use of an extended proportional hazards, multivariate regression model, risk factors associated with decreased survival time included CD4 count <0.20 x 10(9) cells/L (risk ratio [RR], 2.1; 95% confidence interval [CI], 1.3-3.5) compared with >/=0.20 x 10(9) cells/L, whereas factors associated with increased survival time were prescription of antiretroviral medication that contained a protease inhibitor (RR, 0.2; 95% CI, 0.1-0.4) and prescription of other antiretroviral medication (RR, 0.6; 95% CI, 0.5-0.8) compared with no antiretroviral prescription. We conclude that protease inhibitor use (in combination antiretroviral therapy) is likely to favorably affect survival time after diagnosis of PML.
为了研究影响进行性多灶性白质脑病（PML）诊断后生存的因素，我们分析了一项观察性队列研究——成人及青少年HIV疾病谱项目的数据。我们确定了1990年至1997年间被诊断为PML的415名患者。诊断后的中位生存时间为1个月。通过使用扩展比例风险多变量回归模型，与生存时间缩短相关的危险因素包括CD4细胞计数<0.20×10⁹个/L（风险比[RR]，2.1；95%置信区间[CI]，1.3 - 3.5），而与生存时间延长相关的因素是使用含有蛋白酶抑制剂的抗逆转录病毒药物（RR，0.2；95% CI，0.1 - 0.4）以及使用其他抗逆转录病毒药物（RR，0.6；95% CI，0.5 - 0.8），与未使用抗逆转录病毒药物相比。我们得出结论，使用蛋白酶抑制剂（联合抗逆转录病毒疗法）可能会对PML诊断后的生存时间产生有利影响。
