Deloumeaux J, Foucan L, Sow-Goerger M T, Contamin B, Strobel M
Département d'Information Médicale et de Santé Publique, CHU de Pointe-à Pitre-Abymes, Guadeloupe.
West Indian Med J. 2000 Jun;49(2):148-53.
The study objective was to describe morbidity and mortality from HIV infection and the acquired immunodeficiency syndrome (AIDS) in Guadeloupe from 1988 to 1997 and to evaluate survival and prognostic factors. The HIV infected patients database of Guadeloupe included 1771 adult patients up to December 31, 1997. Annual incidence of AIDS defining illnesses was calculated and compared using Poisson regression. Survival analysis with log-rank test and multivariate analysis with Cox's model were performed for patients with AIDS. At the end of December 1997, 599 cases of AIDS (33.8%) and 367 deaths (20.7%) were reported. For 32.1% of the patients, AIDS was diagnosed before inclusion. Incidence of most AIDS-defining events decreased over time, especially after the introduction of protease inhibitor therapy. Before the introduction of protease inhibitors in September 1996, overall median survival after AIDS diagnosis was 11.8 months (95% Confidence Interval (CI), 95% CI 10.2-14.1). After this date median survival increased to 17.8 months (95% CI 18.6-22.5) and probability of survival was significantly higher for patients treated with protease inhibitor in combination regimen (mean 19.0 months, Standard deviation (SD) 1.3) compared to those who were not (mean 7.9 months, SD 0.6, p < 0.0001). Prognosis factors of death after AIDS were older age (Relative Hazard, RH: 1.17, 95% CI 1.07-1.28), occurrence of two or more AIDS-defining events at the beginning of the disease (RH: 1.70, 95% CI 1.32-2.19), and a CD4 cell count less than 50/mm3 (RH: 2.33, 95% CI 1.71-3.17). On the other hand, occurrence of AIDS during follow-up had a better prognosis (RH: 0.68, 95% CI 0.52-0.89) and protease inhibitor therapy was strongly associated with a longer survival (RH 0.26, 95% CI 0.13-0.53). We concluded that HIV infection in Guadeloupe was frequently diagnosed at the stage of AIDS. However, survival of patients and trends of major AIDS defining illnesses were more similar to the European pattern than to the Caribbean one, as a consequence of the availability of modern therapy.
该研究的目的是描述1988年至1997年瓜德罗普岛HIV感染及获得性免疫缺陷综合征（AIDS）的发病率和死亡率，并评估生存率及预后因素。截至1997年12月31日，瓜德罗普岛的HIV感染患者数据库包含1771名成年患者。使用泊松回归计算并比较AIDS确诊疾病的年发病率。对AIDS患者进行对数秩检验的生存分析以及使用Cox模型的多变量分析。1997年12月底，报告了599例AIDS（33.8%）和367例死亡（20.7%）。32.1% 的患者在纳入研究前被诊断为AIDS。大多数AIDS确诊事件的发病率随时间下降，尤其是在引入蛋白酶抑制剂治疗后。在1996年9月引入蛋白酶抑制剂之前，AIDS诊断后的总体中位生存期为11.8个月（9
