在高效抗逆转录病毒治疗时代，艾滋病痴呆综合征患者的生存率有显著提高。

Marked improvement in survival following AIDS dementia complex in the era of highly active antiretroviral therapy.

作者信息

Dore Gregory J, McDonald Ann, Li Yueming, Kaldor John M, Brew Bruce J

机构信息

National Centre in HIV Epidemiology and Clinical Research, The University of New South Wales, Sydney, Australia.

出版信息

AIDS. 2003 Jul 4;17(10):1539-45. doi: 10.1097/00002030-200307040-00015.

DOI:10.1097/00002030-200307040-00015

PMID:12824792

Abstract

OBJECTIVE

To determine the effect of introduction of highly active antiretroviral therapy (HAART) on survival following AIDS dementia complex (ADC).

METHODS

Australian AIDS notification data in the period 1993-2000 were examined. In order to examine the impact of HAART, two periods of AIDS diagnoses were chosen: pre-HAART (1993-1995) and HAART (1996-2000). Median survival was based on Kaplan-Meier estimates, with examination of factors influencing survival in a Cox proportional hazards model.

RESULTS

In the period 1993-2000 in Australia, 5017 initial AIDS illnesses were diagnosed among 4351 AIDS patients. The proportion of AIDS cases with ADC increased from 5.2% in 1993-1995 to 6.8% in 1996-2000 (P = 0.029). Median survival following AIDS increased from 19.6 months for those diagnosed with AIDS in 1993-1995 to 39.6 months for those diagnosed in 1996-2000 (P < 0.0005). Median survival following ADC increased to a greater extent than that for all other AIDS illnesses, from 11.9 months in 1993-1995 to 48.2 in 1996-2000 (P < 0.0005). Most striking was the increase in survival among those with ADC and a CD4 cell count < 100 x 10(6) cells/l at diagnosis; 5.1 months in 1993-1995 to 38.5 months in 1996-2000 (P < 0.0005).

CONCLUSION

Although there has been a proportional increase in ADC at AIDS diagnosis, survival following ADC has improved markedly in the era of HAART.

摘要

目的

确定引入高效抗逆转录病毒疗法（HAART）对艾滋病痴呆综合征（ADC）患者生存的影响。

方法

研究了1993 - 2000年澳大利亚艾滋病报告数据。为了研究HAART的影响，选取了两个艾滋病诊断时期：HAART前（1993 - 1995年）和HAART时期（1996 - 2000年）。中位生存期基于Kaplan - Meier估计值，并在Cox比例风险模型中检验影响生存的因素。

结果

1993 - 2000年期间，澳大利亚4351例艾滋病患者中诊断出5017例初发艾滋病疾病。艾滋病合并ADC病例的比例从1993 - 1995年的5.2%上升至1996 - 2000年的6.8%（P = 0.029）。艾滋病诊断后的中位生存期从1993 - 1995年诊断为艾滋病的患者的19.6个月增加到1996 - 2000年诊断患者的39.6个月（P < 0.0005）。ADC诊断后的中位生存期比所有其他艾滋病疾病的增加幅度更大，从1993 - 1995年的11.9个月增加到1996 - 2000年的48.2个月（P < 0.0005）。最显著的是诊断时CD4细胞计数<100×10⁶个/升的ADC患者的生存期增加；从1993 - 1995年的5.1个月增加到1996 - 2000年的38.5个月（P < 0.0005）。