       Document 0236
 DOCN  M9630236
 TI    Frequencies of opportunistic diseases prior to death among HIV-infected
       persons. Community Programs for Clinical Research on AIDS.
 DT    9603
 AU    Chan IS; Neaton JD; Saravolatz LD; Crane LR; Osterberger J; Division of
       Biostatistics, School of Public Health, University of; Minnesota,
       Minneapolis 55414-1380, USA.
 SO    AIDS. 1995 Oct;9(10):1145-51. Unique Identifier : AIDSLINE MED/96098130
 AB    OBJECTIVES: To describe the complete history of major opportunistic
       events experienced by 1883 HIV-infected persons prior to and
       specifically within 6 months of death, and to determine whether the
       frequency of specific events varies according to demographic
       characteristics, risk behaviors or geographic location. DESIGN:
       Descriptive case series. METHODS: Of 6682 HIV-infected individuals
       enrolled in studies sponsored by the Community Programs for Clinical
       Research on AIDS between September 1990 and June 1994, 1883 died during
       follow-up. A complete history of AIDS-defining events was determined for
       these patients by combining medical history data obtained at the time of
       enrollment, new events that occurred during follow-up, and causes of
       death. RESULTS: The most common opportunistic AIDS-defining events these
       1883 patients experienced before death were Pneumocystis carinii
       pneumonia (PCP; 45%), Mycobacterium avium complex (MAC; 25%), wasting
       syndrome (25%), bacterial pneumonia (24%), cytomegalovirus (CMV) disease
       (23%) and candidiasis (esophageal or pulmonary; 22%). In addition, 47%
       of patients experienced two or three AIDS-defining events before death,
       and 22% experienced four or more events. In the 6 months prior to death,
       22% of patients had PCP, 21% had MAC, and 20% had CMV disease.
       Significant sex and ethnic differences were found: bacterial pneumonia
       occurred more often before death in women compared with men; fewer
       blacks and Latinos than whites experienced Kaposi's sarcoma (KS); and
       fewer blacks than whites had CMV disease before death. The percentage of
       patients with KS and CMV also varied by risk behavior. The frequency of
       10 opportunistic diseases varied by geographic region after adjustment
       for demographic characteristics and risk behavior. Of note, many more
       patients in northeastern USA had tuberculosis and fewer had MAC.
       CONCLUSION: A large percentage of individuals with HIV infection
       experienced multiple AIDS-defining opportunistic diseases before death.
       PCP, MAC, wasting syndrome, bacterial pneumonia, CMV disease, and
       candidiasis (esophageal or pulmonary) account for a substantial
       proportion of morbidity associated with HIV infection. More diseases
       varied by geographic location than by demographic characteristics or
       risk behavior of patients. Continued research on the etiology and
       prevention of these diseases and how they relate to one another should
       be a high priority.
 DE    AIDS-Related Opportunistic Infections/ETHNOLOGY/*EPIDEMIOLOGY/
       MORTALITY  Blacks  Cachexia/EPIDEMIOLOGY  Candidiasis/EPIDEMIOLOGY
       Cytomegalovirus Infections/EPIDEMIOLOGY  Female  Hispanic Americans
       Human  Male  Mycobacterium avium-intracellulare Infection/EPIDEMIOLOGY
       Pneumonia, Bacterial/EPIDEMIOLOGY  Pneumonia, Pneumocystis
       carinii/EPIDEMIOLOGY  Risk Factors  Sex Factors  Support, Non-U.S. Gov't
       Support, U.S. Gov't, P.H.S.  Whites  JOURNAL ARTICLE

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

