Villasís-Keever A, Rangel-Frausto M S, Ruiz-Palacios G, Ponce de León-Rosales S
Departamento de Enfermedades Infecciosas, Instituto Nacional de la Nutrición Salvador Zubirán, Mexico City, Mexico.
Arch Med Res. 2001 Jan-Feb;32(1):62-5. doi: 10.1016/s0188-4409(00)00263-0.
Our objective was to evaluate survival trends (1984-1995), the prevalence of AIDS-defining conditions, and the role of treatment with zidovudine and/or prophylaxis with trimethoprim-sulfamethoxazole (TMP-SMX) in survival following AIDS diagnosis.
We reviewed the clinical charts and postmortem studies of all patients admitted to the HIV Clinic from 1984-1995. Three groups were identified according to the following dates of HIV diagnosis: 1) 1984-1988; 2) 1989-1992, and 3) 1993-1995.
We studied 909 charts. During the study period, 744 (81.6%) patients developed AIDS. Median survival increased from 11.7 months in group 1 to 15.4 and 17.5 months in groups 2 and 3, respectively (p <0.05). We observed the following important changes in the frequency of AIDS-defining conditions over the study period: Pneumocystis carinii pneumonia (PCP) decreased from 24.8 to 17 and 14% in groups 1, 2, and 3, respectively, (p = 0.008), and Kaposi's sarcoma (KS), from 31.1 to 10.5 and 13.5% (p <0.001). On the other hand, there was an increase in cytomegalovirus disease with 12.4, 20.4, and 18.6% (p = 0.04) and wasting syndrome with 36, 45, and 57% (p <0.001). In the proportional hazard model for death, zidovudine or TMP-SMX use was associated with a protective effect.
Survival is improving among patients with HIV infection at our institution. The prevalence of AIDS-defining conditions has changed over the last 12 years. There has been a diminution of PCP and KS, whereas cases of CMV disease and wasting syndrome increased.
我们的目标是评估生存趋势（1984 - 1995年）、艾滋病界定疾病的患病率，以及齐多夫定治疗和/或甲氧苄啶 - 磺胺甲恶唑（TMP - SMX）预防在艾滋病诊断后生存中的作用。
我们回顾了1984年至1995年期间入住艾滋病诊所的所有患者的临床病历和尸检研究。根据以下艾滋病病毒诊断日期确定了三组：1）1984 - 1988年；2）1989 - 1992年；3）1993 - 1995年。
我们研究了909份病历。在研究期间，744名（81.6%）患者发展为艾滋病。中位生存期从第1组的11.7个月分别增加到第2组和第3组的15.4个月和17.5个月（p <0.05）。在研究期间，我们观察到艾滋病界定疾病频率的以下重要变化：卡氏肺孢子虫肺炎（PCP）在第1、2和3组中分别从24.8%降至17%和14%（p = 0.008），卡波西肉瘤（KS）从31.1%降至10.5%和13.5%（p <0.001）。另一方面，巨细胞病毒病增加，分别为12.4%、20.4%和18.6%（p = 0.04），消瘦综合征增加，分别为36%、45%和57%（p <0.001）。在死亡的比例风险模型中，使用齐多夫定或TMP - SMX具有保护作用。
我们机构中感染艾滋病病毒的患者的生存率正在提高。在过去12年中，艾滋病界定疾病的患病率发生了变化。PCP和KS有所减少，而巨细胞病毒病和消瘦综合征的病例增加。
