Prognosis of HIV-1-infected patients starting highly active antiretroviral therapy: a collaborative analysis of prospective studies.

Mortality of HIV-1-infected patients in the first year of antiretroviral therapy: comparison between low-income and high-income countries.

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(99)01122-8.pdf

Clinical progression and virological failure on highly active antiretroviral therapy in HIV-1 patients : a prospective cohort study

Antiretroviral therapy has dramatically improved survival of HIV-infected individuals and reduced the incidence of AIDS-defining cancer but may have—directly or indirectly—increased cases of non–AI...

Incidence of Types of Cancer among HIV-Infected Persons Compared with the General Population in the United States, 1992–2003

https://www.who.int/hiv/events/artprevention/sterne.pdf

Timing of initiation of antiretroviral therapy in AIDS-free HIV-1-infected patients: a collaborative analysis of 18 HIV cohort studies.

Objective: To determine the incidence of AIDS-defining opportunistic infections and malignancies over a 5-year period from 1992 to 1996. Study population: Subcohort of 1003 homosexual men with HIV infection and CD4 count less than 200 x 10 6 cells/l from the Frankfurt AIDS Cohort Study. Methods: Data including the earliest date that a CD4 T-lymphocyte count < 200 x 10 6 /l was reached and the dates of AIDS-defining events were compiled from medical records. Incidence analyses for AIDS-defining events and death during the subsequent 5 years (1992-1996) were performed using rates per 100 person-years of exposure. Results: During the observation period, the number of patients per year with CD4 T-lymphocyte counts < 200 x 10 6 /l varied between 402 and 511. In 1992, 56.7%, of patients experienced at least one AIDS-defining illness, and 20.7% in 1996. The annual number of AIDS-defining events per 100 patient-years of observation declined from 143.5 in 1992 to 38.3 in 1996, and the number of AIDS-related deaths fell from 25.7 to 12.9. Analysis of the number of events confirmed this trend for malignancies and single opportunistic infections, with the exception of mycobacterial diseases. Conclusions: The incidence of AIDS-defining events in patients with advanced HIV infection at Frankfurt University Hospital has declined by more than 70%, from 1992 to 1996.

Changing incidence of AIDS-defining illnesses in the era of antiretroviral combination therapy.

Objective To determine the effect of Kaposi's sarcoma on survival of HIV-infected patients. Methods Retrospective cohort study to compare the survival of 241 HIV-infected homosexual patients with Kaposi's sarcoma (cases) with that of 241 HIV-infected homosexual patients without Kaposi's sarcoma (control subjects) but with a similar level of immunosuppression (measured by the absolute CD4+ lymphocyte count). Results Cases and control subjects were similar in age, occurrence of previous opportunistic infections, and the use of antiretroviral therapy. The mean CD4+ lymphocyte counts were similar for cases and control subjects (185 x 10(6) versus 184 x 10(6)/l, respectively). Cases had a higher incidence of opportunistic infections (5.95 versus 3.88 infections, respectively, per 100 person-months of observation) and a greater number of infections typical of late-stage HIV infection. Cases had a shorter overall survival than did control subjects (P=0.0025). Kaposi's sarcoma was associated with an increased risk of death (odds ratio, 1.28), even when adjusting for age, previous opportunistic infection, baseline CD4+ lymphocyte count, and antiretroviral therapy. Conclusion Kaposi's sarcoma appears to accelerate the clinical course of HIV infection. Opportunistic infections develop earlier and more often in patients with the disease than in control subjects. Survival was significantly shorter in patients with Kaposi's sarcoma.

Bernd S. Kamps

Papers

Changing incidence of AIDS-defining illnesses in the era of antiretroviral combination therapy.

Kaposi's sarcoma in HIV infection: impact on opportunistic infections and survival.