Armbruster C, Kriwanek S, Vorbach H
2nd Medical Department, Pulmologisches Zentrum Vienna.
Wien Klin Wochenschr. 2000 Sep 15;112(17):754-60.
In order to evaluate natural history, clinical features, and socioeconomic aspects in HIV-infected women, a prospective study comprising 695 HIV-infected patients was performed at our department.
Demographic data, CD4+ T-lymphocyte counts, human immunodeficiency virus-1 (HIV-1) plasma loads, AIDS indicator diseases and socioeconomic variables were recorded. Prognostic factors for survival were evaluated by univariate and multivariate analysis. Data of men and women were compared.
The mean age of the 150 women (29.4 +/- 9.4 years) was significantly lower than that of men (32.6 +/- 9.7 years, p = 0.0002). CD4+ T-lymphocyte counts, HIV1-plasma loads, and AIDS indicator diseases did not significantly differ between men and women; the same was true for all socioeconomic variables (family status, education, professional training, employment status) except family status. No significant difference in median overall and AIDS-free survival was observed between females (2033 and 1593 days) and males (1554.5 and 1235 days, respectively, p = 0.36 and p = 0.098). Overall survival compared by age groups (< 30, 31-50, > 50 years), by risk categories (homosexuals, i.v. drug users, heterosexual contacts) and by CD4+ T-lymphocyte count (< 200, 200-500, > 500 cells/mm3), differed significantly (p < 0.001) as did AIDS-free survival. Lower age and a high CD4+ T-lymphocyte count were independently associated with the outcome in the multivariate analysis. (Overall survival/relative risk: 0.49 for age < 30 years and 2.3 for CD4+ T-lymphocyte count < 200 cells/mm3, AIDS-free survival/relative risk: 0.65 for age < 30 years and 3.3 for CD4+ T-lymphocyte count < 200 cells/mm3). HIV-1 plasma loads as a prognostic factor could not be evaluated due to the small number of patients who died or developed AIDS (2/375 and 10/375 patients, respectively).
Our results showed no difference in the natural history and clinical features of HIV infection between men and women. However, pulmonary tuberculosis was associated with a significantly longer survival compared to other AIDS-defining diseases. Lower age and high CD4+ T-lymphocyte count are independent predictors for survival. With the exception of family status, socioeconomic variables showed no differences between male and female patients.
为了评估感染人类免疫缺陷病毒（HIV）的女性的自然病史、临床特征及社会经济状况，我们科室对695例HIV感染患者进行了一项前瞻性研究。
记录人口统计学数据、CD4+ T淋巴细胞计数、人类免疫缺陷病毒1型（HIV-1）血浆载量、艾滋病指征性疾病及社会经济变量。通过单因素和多因素分析评估生存的预后因素。比较男性和女性的数据。
150名女性的平均年龄（29.4±9.4岁）显著低于男性（32.6±9.7岁，p = 0.0002）。男性和女性之间的CD4+ T淋巴细胞计数、HIV-1血浆载量及艾滋病指征性疾病无显著差异；除家庭状况外，所有社会经济变量（家庭状况、教育程度、职业培训、就业状况）均无显著差异。女性（分别为2033天和1593天）和男性（分别为1554.5天和1235天）的中位总生存期和无艾滋病生存期无显著差异（p = 0.36和p = 0.098）。按年龄组（<30岁、31 - 50岁、>50岁）、风险类别（同性恋者、静脉吸毒者、异性接触者）及CD4+ T淋巴细胞计数（<200、200 - 500、>500个细胞/mm³）比较的总生存期有显著差异（p < 0.001），无艾滋病生存期亦如此。在多因素分析中，较低年龄和较高的CD4+ T淋巴细胞计数与预后独立相关。（总生存期/相对风险：<30岁年龄组为0.49，CD4+ T淋巴细胞计数<200个细胞/mm³为2.3；无艾滋病生存期/相对风险：<30岁年龄组为0.65，CD4+ T淋巴细胞计数<200个细胞/mm³为3.3）。由于死亡或发生艾滋病的患者数量较少（分别为2/375和10/375例患者），无法评估HIV-1血浆载量作为预后因素。
我们的结果显示，男性和女性HIV感染的自然病史和临床特征无差异。然而，与其他艾滋病界定疾病相比，肺结核与显著更长的生存期相关。较低年龄和较高的CD4+ T淋巴细胞计数是生存的独立预测因素。除家庭状况外，男性和女性患者的社会经济变量无差异。
