Document 1133
 DOCN  M94A1133
 TI    Influence on zidovudine/Pneumocystis carinii pneumonia prophylaxis on
       survival from AIDS diagnosis.
 DT    9412
 AU    Mijch A; Carlin J; Hoy J; Gertig D; Graham M; Lucas R; Fairfield
       Hospital, Victoria, Australia.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(2):201 (abstract no. PB0819). Unique
       Identifier : AIDSLINE ICA10/94371442
 AB    BACKGROUND: There have been substantial improvements in the treatment of
       AIDS over the last decade with the introduction of Zidovudine (ZDV) and
       other antivirals and with the widespread use of prophylaxis for
       opportunistic infections especially Pneumocystis carinii pneumonia
       (PCP). However the effects of these interventions on survival are not
       yet clear. AIM: To examine changes in survival from diagnosis of AIDS
       over time in patients treated at a single institution; to compare
       patterns of AIDS Defining Illness (ADI) and CD4 lymphocyte counts; to
       compare survival between those patients who received ZDV and PCP
       Prophylaxis (PCP Px) prior to AIDS diagnosis with those treated after
       AIDS diagnosis. METHODS: A retrospective case review of all patients
       treated from 1987 to 1992 at a major treatment centre. 151 patients had
       received ZDV and PCP Px prior to AIDS defining illness and 186 had
       received treatment after AIDS diagnosis. Survival was calculated from
       the date of AIDS to death or to 31/12/92. Analysis of age at AIDS
       diagnosis, year of diagnosis, CD4 count within 60 days of AIDS and ADI
       was undertaken. RESULTS: The median survival for the group receiving ZDV
       and PCP Px prior to AIDS was 383 days (12.8 months) and that for
       patients treated after AIDS diagnosis was 629 days (21 months). Using p
       value multivariate analysis only prior therapy were shown to be
       associated with survival from AIDS diagnosis. CD4 counts at AIDS
       diagnosis were significantly lower in the group receiving therapy before
       AIDS diagnosis (median 30/mean 54 in the ZDV/PCP Px prior to AIDS group
       v 61.5/122 in those treated after AIDS diagnosis). The proportion of
       patients with PCP as their ADI was reduced with treatment prior to AIDS
       (29% in the ZDV/PCP Px prior to AIDS group v 59% in those treated after
       AIDS diagnosis). CONCLUSION: In this patient population therapy with ZDV
       and PCP Px appeared to delay the onset of AIDS until a lower CD4 count
       but was associated with a significantly reduced survival from AIDS
       diagnosis.
 DE    Acquired Immunodeficiency Syndrome/DRUG THERAPY/IMMUNOLOGY/  *MORTALITY
       AIDS-Related Opportunistic Infections/*PREVENTION & CONTROL  Human
       Leukocyte Count  Pneumonia, Pneumocystis carinii/*PREVENTION & CONTROL
       Survival Rate  T4 Lymphocytes  Zidovudine/*THERAPEUTIC USE  MEETING
       ABSTRACT

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