Survival differences in patients with AIDS

Article Abstract:

Differences in survival rates were studied in 526 AIDS patients who were diagnosed through September 1987 at Montefiore Medical Center and North Central Bronx Hospital in New York City. The patients were representative of the populations who develop AIDS, being of diverse racial and ethnic backgrounds, representing many ages, and including men and women from all risk behavior groups, except hemophiliacs. However, study population came from a single geographic area, were of similar socioeconomic status and received comparable health care. Only 17 (3 percent) of the patients were treated with zidovudine, and prior to 1985 no patient received prophylactic (preventative) treatment for Pneumocystis carinii pneumonia. The results revealed that the first symptoms that developed and resulted in the diagnosis of AIDS were the best predictor of survival. Patients whose first clinical symptom was Kaposi's sarcoma had an average survival time of 12.8 months. Those presenting with Pneumocystis carinii pneumonia had an average survival time of 10.9 months, while the average survival of patients who presented with other infections or cancers was only 4.8 months. When subpopulations were compared, men of younger age (under 35 years of age) had a more favorable survival rate. Of all the combinations of clinical, demographic and behavioral conditions, AIDS patients with Pneumocystis carinii pneumonia who were male, black, young, and used intravenous drugs survived longest. Because of the effectiveness of zidovudine treatment for AIDS and prophylaxis treatment for preventing Pneumocystis carinii pneumonia, future patterns of survival will be different. Therefore, this study provides data of survival rates among AIDS patients before effective treatments were available. The data from this study can be used as a historical control for various treatments used after 1987. (Consumer Summary produced by Reliance Medical Information, Inc.)

Prognosis, Demographic aspects, Surveys, AIDS (Disease), North Central Bronx Hospital (New York, New York), Montefiore Medical Center (New York, New York)

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Cervical cytologic abnormalities and papillomavirus in women infected with human immunodeficiency virus

Article Abstract:

HIV (human immunodeficiency virus) causes suppression of the immune system, which may allow infection with human papillomavirus (HPV) to occur or persist. HPV is implicated in the development of cervical intraepithelial neoplasia, that is, abnormal growth of tissue of the cervix. The relationship between HIV infection and HPV infection of the genital tract was examined in 67 women, including 48 women who used intravenous drugs, 18 who were sexual partners of HIV-infected men who used intravenous drugs, and one who developed infection with HIV after undergoing blood transfusion. The patients received a Pap smear, cervical and vaginal cells were obtained by lavage so that cellular DNA could be examined for the presence of HPV, their blood was tested for antibodies against HIV, and they were examined for other sexually transmitted diseases. Forty-nine percent (17 out of 35) of the women who were infected with HIV, as revealed by antibodies against HIV in their blood, were also infected with HPV, compared with only 25 percent (8 out of 32) of the women who were not infected with HIV. When cells from the cervix were examined, 40 percent (14 out of 35) of the women who were infected with HIV had abnormalities known as squamous intraepithelial lesions, compared with nine percent (3 out of 32) of the women who were not infected with HIV. Of the women who were infected with HIV, 50 percent (11 out of 22) of those with symptoms of HIV infection had squamous intraepithelial lesions, compared with 23 percent (3 out of 13) of those who were infected with HIV but did not have any symptoms. This study shows that HIV infection is associated with the increased incidence of HPV infection and the cellular abnormalities of the cervical cells that HPV is known to cause. (Consumer Summary produced by Reliance Medical Information, Inc.)

Development and progression, Cervix diseases, Virus-induced immunosuppression

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Cervical and vaginal squamous cell abnormalities in women infected with human immunodeficiency virus

Article Abstract:

Women whose immune systems are suppressed have a greater risk of human papillomavirus (HPV) infections. HPV infection is associated with the development of precancerous disease or cancer in the lower genital tract. The association between HPV infection and human immunodeficiency virus (HIV) infection in women was examined. Cell abnormalities in cervicovaginal smears from women who were infected with HIV were compared with those from women who were not infected. Eleven out of 35 (31 percent) of HIV-infected women had cell abnormalities compared with 1 out of 23 (4 percent) of women who were not infected. Nine of the 35 (26 percent) women who were infected with HIV were also infected with HPV, compared with 1 out of 23 (4 percent) of the women who were not infected. When other factors that may have contributed to the development of cellular abnormalities and HPV infection were examined, it was found that the women who were infected with HIV had an increased incidence of sexually transmitted diseases, a decreased use of barrier contraceptives, a shorter time interval since sexual contact with an individual with AIDS, and decreased numbers of T helper cells (indicating suppression of the immune system), compared with those with were not infected with HIV. Therefore, women who are infected with HIV have a high chance of having abnormalities in the cells of their vagina and cervix and of having HPV infection. Further study is necessary to see if women who are infected with HIV have an increased risk of developing cancer in their lower genital tract. (Consumer Summary produced by Reliance Medical Information, Inc.)

Infection, Causes of, Cervix dysplasia, Pathology, Cellular, Cytopathology, Genitourinary organs, Urogenital system

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