Hanson D L, Horsburgh C R, Fann S A, Havlik J A, Thompson S E
Division of HIV/AIDS, Centers for Disease Control, Atlanta, Georgia 30333.
J Acquir Immune Defic Syndr (1988). 1993 Jun;6(6):624-9.
Previous studies of survival after a diagnosis of acquired immunodeficiency syndrome (AIDS) have reported variation in temporal trends in association with age, gender, race, mode of transmission, lymphadenopathy, antiretroviral therapy, and presence of specific opportunistic infections at diagnosis. We used a logistic regression model to assess the effect of these factors while controlling for other potential predictors of time from initial CD4 cell count to death in 839 HIV-infected patients at a public hospital in Atlanta, Georgia. Our study found that a CD4 level of < 200 cells/microliters [odds ratio (OR) = 1.71; 95% confidence interval (CI) of 1.58, 1.85] and the presence of an AIDS-indicating condition (initial diagnosis OR = 2.50 and CI of 1.93, 3.24; diagnosis of a second AIDS condition OR = 3.02 and CI of 2.08, 4.40) are independently predictive of survival in HIV-infected persons. Furthermore, specific clinical manifestations of AIDS vary in their contribution to progression from diagnosis of AIDS to death. Therefore, changes in survival of AIDS patients must take into account changes over time in the relative frequency of specific AIDS-indicating diagnoses.
先前关于获得性免疫缺陷综合征（AIDS）诊断后生存情况的研究报告称，与年龄、性别、种族、传播方式、淋巴结病、抗逆转录病毒疗法以及诊断时特定机会性感染的存在相关的时间趋势存在差异。我们使用逻辑回归模型来评估这些因素的影响，同时在佐治亚州亚特兰大市一家公立医院的839名HIV感染患者中，控制从初始CD4细胞计数到死亡时间的其他潜在预测因素。我们的研究发现，CD4水平<200细胞/微升[比值比（OR）=1.71；95%置信区间（CI）为1.58，1.85]以及存在AIDS指征性疾病（初次诊断时OR=2.50，CI为1.93，3.24；第二次AIDS疾病诊断时OR=3.02，CI为2.08，4.40）可独立预测HIV感染者的生存情况。此外，AIDS的特定临床表现对从AIDS诊断到死亡进展的贡献各不相同。因此，AIDS患者生存情况的变化必须考虑特定AIDS指征性诊断相对频率随时间的变化。
