Survival following diagnosis of Kaposi's sarcoma for AIDS patients in San Francisco

Article Abstract:

Survival following diagnosis of AIDS varies according to the initial signs of the disease. In earlier studies, patients whose first clinical sign of AIDS was Kaposi's sarcoma (KS) survived longer than patients whose first symptoms were Pneumocystis carinii pneumonia (PCP) or other opportunistic infections and malignancies. However, studies from recent years have shown an increasing survival rate in patients diagnosed with PCP, probably due to treatment with zidovudine, but a decrease in survival for those diagnosed with KS. The rate of survival following the diagnosis of KS in AIDS patients was examined in 1,015 patients from San Francisco from July 1981 through December 1987. These patients were followed through to December 1988. The patients were all males, and 88 percent were homosexual or bisexual men who did not use intravenous drugs. The patients had a definite diagnosis of KS, and developed no other symptoms within three months of diagnosis. The median survival time was 17 months for patients diagnosed with KS alone, with a five-year survival rate of 8.7 percent. Predictors of survival were age and year of diagnosis. Decreased survival rates were seen with increasing age at time of diagnosis. Survival was longer for patients diagnosed in the earlier years of the study (1981 to 1983) compared with those diagnosed in 1984 or later. Possible reasons for the poorer prognosis in later years include: change in the prevalence of a behavioral or infectious cofactor; a more aggressive tumor; and the development of KS later in the course of AIDS. Race or ethnicity and risk group were not found to be predictors of survival rate in KS patients. Therefore, there is a trend of shortened survival times for AIDS patients with KS in recent years, especially in those who are older at the time of diagnosis. (Consumer Summary produced by Reliance Medical Information, Inc.)

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Survival trends for patients with AIDS

Article Abstract:

The duration of survival time from diagnosis of AIDS (acquired immunodeficiency syndrome) to death was evaluated for 4,323 persons living in San Francisco. These cases were reported to the public health department between July 1981 and December 31, 1987 and were followed until death or through the end of the study in December 1988. The average survival time was 12.5 months. Only 3.4 percent lived for at least five years following diagnosis and the patient with the longest recorded survival lived 8.1 years. Survival was better for patients who were diagnosed with Pneumocystis carinii pneumonia during 1986 and 1987, but mortality increased from 1981 to 1987 for persons diagnosed with Kaposi's sarcoma, a form of skin cancer. No change in mortality was observed among AIDS patients with other opportunistic infections or complications. Patients between the ages of 20 and 39 lived the longest, while both younger and older individuals had shorter survival times. Men lived longer than women, but few cases of women with AIDS were reported. Patients treated with zidovudine (AZT) survived longer than patients who received no antiviral therapy. Data were lacking on the use of treatments other than antiviral drugs, so their influence on mortality could not be evaluated. In conclusion, short-term survival has improved in recent years for some AIDS patients, and new treatments such as zidovudine may be responsible. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, HIV (Viruses), HIV, AIDS patients, Zidovudine, San Francisco

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The epidemiology of AIDS-related Kaposi's sarcoma in San Francisco

Article Abstract:

The number of individuals with AIDS that develop Kaposi's sarcoma is declining in the United States, and the reason for the decline is not known. The number of cases of AIDS-related Kaposi's sarcoma in San Francisco was reviewed through August 31, 1990. Of the 7,119 patients with AIDS who were reported, 2,346 (33 percent) were diagnosed as having KS. In 73 percent of the KS cases, the development of KS was the first clinical symptom of AIDS, and in the other 27 percent of the cases it was a later symptom. Eight-eight percent of the patients with KS were homosexual or bisexual men without previous use of intravenous drugs, while 12 percent were homosexual or bisexual men who had used intravenous drugs. The total number of patients with AIDS and the number of cases of KS have both increased from 1981 to August 1989. However, the proportion of AIDS patients with KS has declined from 55 to 19 percent in this time period. It is concluded that the decline is not due to underreporting of KS compared with other manifestations of AIDS, and that the proportion of KS cases to AIDS cases is indeed declining. (Consumer Summary produced by Reliance Medical Information, Inc.)

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