Document 2372
 DOCN  M94A2372
 TI    Progression to AIDS in a cohort of ZDV-treated symptomatic patients in
       Italy.
 DT    9412
 AU    Vella S; Barcherini S; Bucciardini R; Mariotti S; 1st. Sup. di Sanita,
       Rome, Italy.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(1):319 (abstract no. PC0205). Unique
       Identifier : AIDSLINE ICA10/94370203
 AB    OBJECTIVE. To compare times of progression to AIDS between I.V.D.U.'s
       and homosexuals in a large cohort of symptomatic patients treated with
       Zidovudine in Italy. METHODS. In a multicenter cohort study of 1495
       patients undergoing ZDV treatment, enrolled by over 100 clinical centers
       in Italy who prospectively followed the patients according to a protocol
       schedule, the progression to AIDS is analyzed for two groups of
       subjects: IVDU's (1120), and homosexuals (171) using Cox's proportional
       hazard model. Enrollment started on July 1, 1987 and cutoff date for the
       study was September 30, 1992. Mean follow-up time was three years.
       RESULTS. Homosexuals showed a relative risk (RR) of progression to AIDS
       30% higher than IVDU's, controlling for confounding variables, such as
       baseline CD4+ count, ZDV dosage, calendar year of treatment beginning,
       opportunistic infections and symptoms at enrollment. Other variables
       associated with an earlier progression were CD4+ counts (RR increases by
       39% for a decrease of 100 counts/mm3), age at enrollment (RR is 13%
       higher for subjects 5 years older), ZDV dosage (RR increases by 26% for
       high vs. low dosage). Among opportunistic infections at enrollment only
       oral candidiasis (RR = 1.27) and fever (RR = 1.77) were found to be
       associated to an early progression. The AIDS defining events were also
       compared: Kaposi's sarcoma was the only event significantly different
       between the two groups. When controlling for the AIDS defining events no
       further difference in risk between the groups is found. CONCLUSIONS. The
       increased risk for homosexuals is mostly explained by the presence of
       Kaposi's sarcoma, as AIDS-defining event. Therefore, it is not possible
       to assess whether the increased risk which appear to exist in
       homosexuals as compared to IVDU's is due only to anticipated diagnosis
       or to an actual increased risk for this category.
 DE    Acquired Immunodeficiency Syndrome/*COMPLICATIONS/DIAGNOSIS/  PREVENTION
       & CONTROL  AIDS-Related Opportunistic Infections  Cohort Studies
       Homosexuality  Human  Male  Prospective Studies  Risk Factors  Sarcoma,
       Kaposi's/ETIOLOGY  Substance Abuse, Intravenous/*COMPLICATIONS
       Zidovudine/*THERAPEUTIC USE  CLINICAL TRIAL  MEETING ABSTRACT
       MULTICENTER STUDY

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