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Survival differences in Austrian patients with the acquired immunodeficiency syndrome

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Abstract

We investigated the association of clinical and demographic factors on survival of the 901 AIDS cases diagnosed until 31 December 1992 and reported to the Austrian Health Authorities up to 20 January 1994. The overall estimated median survival of patients with AIDS increased substantially from 8 months in 1987 to 16 months in 1988, although this increase was not significant by the log-rank test. However, the differences in hazard rates were larger at the beginning of the survival curve: between 1987 and 1988 the proportion surviving at 1 year increased from 41 to 62%, compared to an increase of the proportion surviving at 2 years from 30 to 35% (Breslow test,p value 0.008). AIDS patients diagnosed between 1988 and 1992 (n=755) were analyzed in more detail. Multivariate survival analysis revealed a shorter survival for those with residence in Eastern Austria, recipients of blood products, individuals with unknown transmission risk, those presenting with two AIDS indicator diseases and those with higher age at AIDS diagnosis. Candidal esophagitis as AIDS indicator disease was associated with longer survival. One hundred eighty-eight of the 755 AIDS patients (24.9%) died within the first 3 months after diagnosis of AIDS. We conclude that the survival time for AIDS patients has improved considerably after 1987, but survival is still very poor. Several factors have been shown to predict survival of patients with AIDS in Austria. Death within the first 3 months after the diagnosis of AIDS occurred at a relatively high frequency in Austrian AIDS patients. This may be caused by difficulties in the use of health care facilities or by the lack of awareness of HIV infection before diagnosis of AIDS either by patient or care provider.

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References

  1. Pedersen C, Gerstoft J, Tauris P, et al. Trends in survival of Danish AIDS patients from 1981 to 1989. AIDS 1990; 4: 1111–1116.

    Google Scholar 

  2. Bindels PJ, Poos RMJ, Jong JT, et al. Trends in mortality among AIDS patients in Amsterdam 1982–1988. AIDS 1991; 5: 853–858.

    Google Scholar 

  3. Fischl MA, Richman DD, Grieco MH, et al. The efficacy of azidothymidine (AZT) in the treatment of patients with AIDS and AIDS-related complex. N Engl J Med 1987; 317: 185–191.

    Google Scholar 

  4. Lundgren JD, Pedersen C, Clumeck N, et al. Survival differences in European patients with AIDS, 1979–89. Br Med J 1994; 308: 1068–1073.

    Google Scholar 

  5. Centers for Disease Control-Update. Acquired immunodeficiency syndrome (AIDS) — United States. MMWR 1982; 31: 507–514.

    Google Scholar 

  6. Centers for Disease Control-Update. Revision of he case definition of acquired immunodeficiency syndrome for national reporting. MMWR 1985; 34: 374–375.

    Google Scholar 

  7. Centers for Disease Control-Update. Revision of the CDC surveillance case definition of the acquired immunodeficiency syndrome. MMWR 1987; 36: 3s-5s.

    Google Scholar 

  8. BMDP Statistical Software. BMDP Statistical Software Manual, edited by W.J. Dixon. Berkeley: University of California Press, 1992.

  9. Lemp GF, Payne SF, Neal D, Temelso T. Survival trends for patients with AIDS. JAMA 1990; 263: 402–406.

    Google Scholar 

  10. Hardy WD, Feinberg J, Finkelstein DM, et al. A controlled trial of trimethoprim-sulfamethoxazole or aerosolized pentamidine for secondary prophylaxis of Pneumocystis carinii pneumonia in patients with acquired immunodeficiency syndrome. N Engl J Med 1992; 327: 1842–1848.

    Google Scholar 

  11. Schneider MME, Hoepelman AIM, Schattenkerk JKME, et al. A controlled trial of aerosolised pentamidine or trimethoprim-sulfamethoxazole as primary prophylaxis against Pneumocystis carinii pneumonia in patients with human immunodeficiency virus infection. N Engl J Med 1992; 327: 1836–1841.

    Google Scholar 

  12. Osmond D, Charlebois E, Lang W, et al. Changes in AIDS survival time in two San Francisco cohorts of homosexual men, 1983 to 1993. JAMA 1994; 271: 1083–1087.

    Google Scholar 

  13. Moore RD, Hidalgo J, Sugland BW, Chaisson E. Zidovudine and the natural history of the acquired immunodeficiency syndrome. N Engl J Med 1991; 324: 1412–1416.

    Google Scholar 

  14. Vella S, Giuliano M, Pezzotti P, et al. Survival of zidovudine-treated patients with AIDS compared with that of contemporary untreated patients. JAMA 1992; 267: 1232–1236.

    Google Scholar 

  15. Lundgren JD, Phillips AN, Pedersen C, et al. Comparison of long-term prognosis of patients with AIDS treated and not treated with Zidovudine. JAMA 1994; 271: 1088–1092.

    Google Scholar 

  16. Maden C, Hopkins SG, Smyser M, Lafferty WE. Survival after AIDS diagnosis in Washington State: trends through 1989 and effect of the case definition change of 1987. J AIDS 1993; 6: 1157–1161.

    Google Scholar 

  17. Whitmore-Overton SE, Tillett HE, Evans BG, Allardice GM. Improved survival from diagnosis of AIDS in adult cases in the United Kingdom and bias due to reporting delays. AIDS 1993; 7: 415–420.

    Google Scholar 

  18. Luo K, Law M, Kaldor JM, et al. The role of initial AIDS-defining illness in survival following AIDS. AIDS 1995; 9: 57–63.

    Google Scholar 

  19. Phillips AN, Antunes F, Stergious G, et al. A sex comparison of rates of new AIDS-defining disease and death in 2554 AIDS cases. AIDS 1994; 8: 831–835.

    Google Scholar 

  20. Batalla J, Gatell JM, Caylà JA, et al. Predictors of the survival of AIDS cases in Barcelona, Spain. AIDS 1989; 3: 355–359.

    Google Scholar 

  21. Porter K, Wall PG, Evans BG. Factors associated with lack of awareness of HIV infection before diagnosis of AIDS. Br Med J 1993; 307: 20–23.

    Google Scholar 

  22. Delmas MC, Schwoebel V, Heisterkamp SH, et al. Recent trends in Pneumocystis carinii pneumonia (PCP) as AIDS-defining disease in nine European countries. J AIDS (in press).

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Zangerle, R., Reibnegger, G. & Klein, JP. Survival differences in Austrian patients with the acquired immunodeficiency syndrome. Eur J Epidemiol 11, 519–526 (1995). https://doi.org/10.1007/BF01719303

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