Document 2383
 DOCN  M94A2383
 TI    AIDS mortality rates and factors related to survival in a cohort of
       homosexual men. VLAS Study.
 DT    9412
 AU    Craib KJ; Strathdee SA; Hogg RS; Le TN; Montaner JS; O'Shaughnessy MV;
       Schechter MT; UBC & BC Centre for Excellence in HIV/AIDS, Vancouver,
       Canada.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(1):317 (abstract no. PC0197). Unique
       Identifier : AIDSLINE ICA10/94370192
 AB    OBJECTIVE: To determine AIDS-related mortality rates and describe
       factors associated with survival in the Vancouver Lymphadenopathy-AIDS
       Study (VLAS) cohort of seropositive gay men. METHODS: 364 HIV+ men (234
       seroprevalent-SP, 130 seroincident-SI) have been followed in the VLAS
       cohort since 12/82. Cumulative and annual HIV/AIDS mortality rates were
       obtained using Kaplan-Meier methods. Imputed lead times were applied to
       SP men. Relative risk (RR) regression was used to investigate the effect
       of demographic variables, CD4 count and zidovudine use (ZDV) on
       survival. In the latter, CD4 count was a continuous time-dependent
       covariate (TDC), and ZDV was a binary TDC. RESULTS: Subjects were
       followed a median of 9.5 yrs (range = 1.8-13.1). As of 12/31/93, a total
       of 135 AIDS-related deaths were observed among the combined groups
       (SP+SI). The cumulative mortality rate in all subjects was 46% (+/- 4.0)
       at 11.5 years. In the SI group, a total of 34 deaths were observed. For
       the SI group, cumulative mortality was 33% (+/- 4.9) at 10 years, and
       annual mortality rates during the 10 year period were 0%, 0%, 2%, 3%,
       3%, 5%, 6%, 6%, 6%, and 7%, respectively. Multivariate analysis of the
       combined groups showed that younger age (RR = 0.69 per decade; p =
       0.011), enrollment income > $10,000 (RR = 0.635; p = 0.029) and higher
       CD4 count (RR = 0.60 per 100 cells; p < 0.001) were associated with
       longer survival. After adjustment for these variables, ZDV did not have
       a significant effect on the model (p = 0.796). When the analysis was
       restricted to SI, the relative risk for enrollment income > $10,000 was
       unchanged (RR = 0.67) though this was no longer significant due to
       smaller numbers. CONCLUSIONS: We confirmed that younger age is
       associated with longer survival from HIV infection to death. Higher CD4
       count was a strong predictor of longer survival. Interestingly, men with
       incomes over $10,000 at baseline had significantly longer survival from
       HIV to death. This cannot be attributed to 'downward drift' (ie. income
       loss as a result of prior HIV infection in SP subjects) as the same
       effect was observed for SI men. It is also unlikely due to unequal care
       because subjects were in a cohort study within a universal health care
       system with free drugs. The mechanism of this SES effect requires
       further study.
 DE    Acquired Immunodeficiency Syndrome/DRUG THERAPY/*MORTALITY  Age Factors
       Cohort Studies  Homosexuality/*STATISTICS & NUMER DATA  Human  Income
       Leukocyte Count  Male  Risk Factors  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).