[Survival of patients following the diagnosis of AIDS in the Amsterdam region, 1982-1991].

OBJECTIVE

To evaluate the survival of 975 AIDS patients diagnosed in the Amsterdam region between 1982 and 1991, with follow-up until December 31st, 1992.

METHODS

Analysis of data from the active AIDS surveillance system for the Amsterdam region at the Municipal Health Service.

RESULTS

Amsterdam region residents had 1, 2 and 3-year survivals of 69.8%, 42.6% and 21.2%, respectively. The 5-year survival was 7.7%. The median survival probability for all patients showed great improvement, from 9 months in 1982-1985 to 26 months in 1990. For patients initially presenting with only Pneumocystis carinii pneumonia (PCP) the greatest improvement occurred between the period 1982-1985 and the year 1986. For patients without PCP the most important improvement occurred one year later. From 1988 onwards no important improvement in the 1-year survival is noticed. The 2-year survival, however, appears still to be increasing. In a Cox proportional hazards model the following variables were found to be independent predictors for survival: age at diagnosis, earliest clinical AIDS manifestations, year of diagnosis and HIV risk group. No differences were seen in the 1 and 2-year survival probabilities for men and women with AIDS. Heterosexual men and women tended to have a poorer survival than intravenous drug users and homosexual and bisexual men.

CONCLUSION

A noticeable improvement in the survival probability with time occurred for AIDS patients living in the Amsterdam region through the years 1982-1991, although the overall survival after AIDS diagnosis is still poor. The 1-year survival appears to have reached a plateau, the 2-year survival is still increasing. Improved clinical experience, awareness of HIV related complaints in high risk groups, better diagnostic methods and the availability of proper medication (prophylactic and treatment) are the most likely explanations of the improvement in survival.