Brettle R P, McNeil A J, Gore S M, Bird A G, Leen C S, Richardson A
Regional Infectious Disease Unit, City Hospital, Edinburgh.
QJM. 1995 Jul;88(7):479-91.
We describe baseline characteristics, enrollment, progression and mortality of the Edinburgh City Hospital HIV cohort. There were 431 men and 191 (31%) women; 439 (71%) infected via injection drug use (IDU); 92 (15%) via homosexual intercourse; 84 (13%) via heterosexual intercourse and 7 from blood products. Median annual rate of CD4 cell loss was 49 (90% range: 15-146); Both homosexual men and patients aged > 40 years at enrollment lost CD4 cells significantly more quickly. In multifactorial analysis controlled for baseline CD4 count and IgA, there was no gender effect, but young patients (< 25 years) progressed significantly more slowly to AIDS (RR 0.4, p = 0.00). Homosexual men progressed significantly more quickly than IDUs, with adjusted relative risks (RR) of 2.9 (p = 0.00), 2.5 (p = 0.01) and 1.5 (p = 0.1) for progression to CDC stage IV, AIDS and death, respectively. The three-year survival rate post-AIDS was 25% (SE 4.3) and there was no gender effect on survival. There was, however, an age effect whereby individuals diagnosed with AIDS in their 40s or later showed poorer survival (RR 1.9, p = 0.04). Zidovudine treatment after an AIDS diagnosis significantly lengthened post-AIDS survival (RR 0.5, p = 0.08).
我们描述了爱丁堡市医院艾滋病毒队列的基线特征、入组情况、病情进展和死亡率。队列中有431名男性和191名女性(占31%);439人(占71%)通过注射吸毒感染;92人(占15%)通过同性性行为感染;84人(占13%)通过异性性行为感染,7人通过血液制品感染。CD4细胞丢失的年中位数率为49(90%范围:15 - 146);入组时,男同性恋者和年龄大于40岁的患者CD4细胞丢失明显更快。在对基线CD4计数和IgA进行控制的多因素分析中,不存在性别效应,但年轻患者(<25岁)进展为艾滋病的速度明显更慢(风险比0.4,p = 0.00)。男同性恋者病情进展明显快于注射吸毒者,进展至疾病控制中心(CDC)IV期、艾滋病和死亡的调整相对风险分别为2.9(p = 0.00)、2.5(p = 0.01)和1.5(p = 0.1)。艾滋病后的三年生存率为25%(标准误4.3),生存情况不存在性别效应。然而,存在年龄效应,即40岁及以后被诊断为艾滋病的个体生存率较差(风险比1.9,p = 0.04)。艾滋病诊断后接受齐多夫定治疗显著延长了艾滋病后的生存期(风险比0.5,p = 0.08)。