       Document 0876
 DOCN  M95A0876
 TI    HIV positive patients first presenting with an AIDS defining illness:
       characteristics and survival.
 DT    9510
 AU    Poznansky MC; Coker R; Skinner C; Hill A; Bailey S; Whitaker L; Renton
       A; Weber J; Department of Genitourinary Medicine and Communicable
       Diseases,; St Mary's Hospital Medical School, London.
 SO    BMJ. 1995 Jul 15;311(6998):156-8. Unique Identifier : AIDSLINE
       MED/95338079
 AB    OBJECTIVES--To study the presentation and survival of patients who
       present with their first diagnosis of being HIV positive at the same
       time as their AIDS defining illness. DESIGN--Retrospective study of
       patients presenting with AIDS between 1991 and 1993. SETTING--Department
       of genitourinary medicine, St Mary's Hospital, London. MAIN OUTCOME
       MEASURES--AIDS defining illness at presentation and survival after
       diagnosis of AIDS. RESULTS--Between January 1991 and December 1993, 97
       out of 436 patients (22%) presented with their first AIDS defining
       illness coincident with their first positive result of an HIV test
       (group B). The remaining 339 patients (78%) had tested positive for
       HIV-1 infection within the previous eight years and had consequently
       been followed up in clinics before developing their first AIDS defining
       illness (group A). The two groups of patients did not differ in age and
       sex distribution, risk factors for HIV-1 infection, nationality, country
       of origin, or haematological variables determined at the time of the
       AIDS defining illness. However, the defining illnesses differed between
       the two groups. Illnesses associated with severe immunodeficiency (the
       wasting syndrome, cryptosporidiosis, and cytomegalovirus infection) were
       seen almost exclusively in group A whereas extrapulmonary tuberculosis
       and Pneumocystis carinii pneumonia were more common in group B. The
       survival of patients in group B after the onset of AIDS was
       significantly longer than that of patients in group A as determined by
       Kaplan-Meier log rank analysis (P = 0.0026). CONCLUSIONS--Subjects who
       are HIV positive and present late are a challenge to the control of the
       spread of HIV infection because they progress from asymptomatic HIV
       infection to AIDS without receiving health care. The finding that
       presentation with an AIDS defining illness coincident with a positive
       result in an HIV test did not have a detrimental effect on survival
       gives insights into the effects of medical intervention on disease
       progression after a diagnosis of AIDS.
 DE    *Acquired Immunodeficiency Syndrome/MORTALITY/THERAPY  Adult  AIDS
       Serodiagnosis  AIDS-Related Opportunistic
       Infections/DIAGNOSIS/*EPIDEMIOLOGY/  MORTALITY  Comparative Study
       Female  Human  *HIV Seropositivity  Lymphoma,
       AIDS-Related/DIAGNOSIS/*EPIDEMIOLOGY/MORTALITY  Male  Retrospective
       Studies  Support, Non-U.S. Gov't  Survival Rate  Time Factors  Treatment
       Outcome  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

