Document 0225
 DOCN  M9440225
 TI    Factors influencing survival after AIDS: report from the Multicenter
       AIDS Cohort Study (MACS).
 DT    9404
 AU    Saah AJ; Hoover DR; He Y; Kingsley LA; Phair JP; Johns Hopkins School of
       Hygiene and Public Health, Baltimore, MD; 21205.
 SO    J Acquir Immune Defic Syndr. 1994 Mar;7(3):287-95. Unique Identifier :
       AIDSLINE MED/94149564
 AB    The objective of this study was to determine if clinical signs,
       symptoms, laboratory variables, and use of therapeutic or prophylactic
       agents have prognostic associations with survival after diagnosis of
       clinical AIDS. A total of 2,168 homosexual men, seropositive for human
       immunodeficiency virus type 1 (HIV-1) participated in a longitudinal
       cohort study of the greater metropolitan areas of Baltimore, Maryland,
       Washington, D.C., Chicago, Illinois, Pittsburgh, Pennsylvania, and Los
       Angeles, California, U.S.A.--the Multicenter AIDS Cohort Study (MACS).
       Variables within 6 months prior to AIDS diagnosis included age, CD4+
       lymphocyte counts, hemoglobin, and self-reported thrush, fever,
       anti-retroviral therapy (ART) beginning prior to AIDS onset, and ART
       beginning after AIDS (as a time-dependent covariate) were analyzed as
       mutually exclusive categories, as was prophylaxis for Pneumocystis
       carinii pneumonia (PCP). Univariate and multivariate survival models of
       time from AIDS to death were fit. In univariate analysis, younger age,
       higher counts of CD4+ lymphocytes, hemoglobin, and absence of thrush or
       fever prior to AIDS onset were associated with longer survival after
       AIDS. Those who began ART within 3 months after AIDS onset had longer
       median survival (1.75 years), from 3 months after AIDS, when compared
       with those who began ART prior to AIDS (1.18 years). This comparison is
       not influenced by the bias that those who survive longer have a greater
       likelihood to subsequently receive ART. Prophylaxis for PCP beginning
       after AIDS onset was also associated with longer post-AIDS survival when
       compared with beginning prophylaxis prior to AIDS or never using
       prophylaxis.(ABSTRACT TRUNCATED AT 250 WORDS)
 DE    Acquired Immunodeficiency Syndrome/BLOOD/DRUG THERAPY/*MORTALITY  Adult
       Analysis of Variance  Antiviral Agents/THERAPEUTIC USE  Cohort Studies
       Hemoglobins/ANALYSIS  Human  Leukocyte Count  Longitudinal Studies  Male
       Multivariate Analysis  Pneumonia, Pneumocystis carinii/PREVENTION &
       CONTROL  Prognosis  Proportional Hazards Models  Prospective Studies
       Support, U.S. Gov't, P.H.S.  Survival Analysis  JOURNAL ARTICLE
       MULTICENTER STUDY

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