Li Y, McDonald A M, Dore G J, Kaldor J M
National Centre in HIV Epidemiology and Clinical Research, The University of New South Wales, Darlinghurst, Australia.
AIDS. 2000 Oct 20;14(15):2349-54. doi: 10.1097/00002030-200010200-00016.
To describe the pattern of survival following AIDS.
National surveillance for AIDS diagnoses.
AIDS cases in adults/adolescents (aged 13 years or older at AIDS diagnosis) and deaths following AIDS were notified to the national HIV surveillance centre by the diagnosing doctor through State/Territory health authorities. The date of last medical contact for each case living with AIDS was updated annually.
By 30 June 1999, 4814 AIDS cases, diagnosed in Australia in 1991-1996, and 3193 deaths following AIDS had been notified to the National AIDS Registry. Median survival following AIDS was 17.7 months. Survival following AIDS increased from 16.0 months in 1991 to 27.7 months in 1996. Factors independently associated with improved survival were year of AIDS diagnosis, late HIV diagnosis, CD4+ cell count greater than 50 x 10(6) cells/l, age of less than 45 years and presentation with Pneumocystis carinii pneumonia only or Kaposi's sarcoma only. The risk of death declined over time when the initial AIDS-defining illness was Pneumocystis carinii pneumonia only [adjusted hazard ratio (AHR) = 0.91, P < 0.0005]; other opportunistic infections (AHR, 0.88; P < 0.0005); Kaposi's sarcoma only (AHR, 0.92; P = 0.025); and central nervous system conditions (HIV encephalopathy, cryptococcosis, toxoplasmosis) (AHR, 0.92; P = 0.012). No time trend was observed for survival following diagnoses of non-Hodgkin's lymphoma or other multiple illnesses.
Survival following AIDS has improved in Australia, especially among cases diagnosed in 1995 and 1996. Temporal improvements in survival following AIDS were coincident with the introduction of combination antiretroviral treatment for HIV infection and suggest that treatment is effective in limiting disease progression among people with advanced HIV infection.
描述艾滋病后的生存模式。
全国艾滋病诊断监测。
诊断医生通过州/领地卫生当局将成人/青少年（艾滋病诊断时年龄为13岁及以上）艾滋病病例及艾滋病后的死亡情况通报给国家艾滋病毒监测中心。每年更新每名艾滋病患者的最后一次医疗接触日期。
截至1999年6月30日，1991 - 1996年在澳大利亚诊断出的4814例艾滋病病例及3193例艾滋病后的死亡情况已通报给国家艾滋病登记处。艾滋病后的中位生存期为17.7个月。艾滋病后的生存期从1991年的16.0个月增加到1996年的27.7个月。与生存期改善独立相关的因素包括艾滋病诊断年份、HIV诊断较晚、CD4 + 细胞计数大于50×10(6)个/升、年龄小于45岁以及仅表现为卡氏肺孢子虫肺炎或仅表现为卡波西肉瘤。当初始艾滋病定义疾病仅为卡氏肺孢子虫肺炎时，死亡风险随时间下降[调整后风险比（AHR）= 0.91，P < 0.0005]；其他机会性感染（AHR，0.88；P < 0.0005）；仅卡波西肉瘤（AHR，0.92；P = 0.025）；以及中枢神经系统疾病（HIV脑病、隐球菌病、弓形虫病）（AHR，0.92；P = 0.012）。非霍奇金淋巴瘤或其他多种疾病诊断后的生存期未观察到时间趋势。
澳大利亚艾滋病后的生存期有所改善，尤其是在1995年和1996年诊断的病例中。艾滋病后生存期的时间改善与引入针对HIV感染的联合抗逆转录病毒治疗同时出现，表明治疗在限制晚期HIV感染者疾病进展方面有效。
