Zidovudine and the natural history of the acquired immunodeficiency syndrome

Article Abstract:

In an analysis of 1,028 cases of AIDS, a trend toward improved survival was observed. Patients receiving a diagnosis of AIDS between 1983 and 1985 survived an average of 310 days after the diagnosis. In contrast, patients diagnosed between 1987 and 1989 survived an average of 450 days. A significant portion of this increased survival is likely to be due to the introduction of zidovudine for the treatment of HIV infection and AIDS. Zidovudine, also known as AZT, became available for use in treatment of HIV infection in April of 1987; the analysis of patient survival since that time has shown that men are more likely to survive for two years than are women, patients under 45 are more likely to survive for two years than are older patients, and non-Hispanic whites are more likely to survive two years than are minority patients. In all these comparisons, the group with the longer survival was also more likely to have taken zidovudine. Since 1987, the average survival of patients given zidovudine was 770 days beyond the day of diagnosis; for patients who were not given zidovudine, the average survival was 190 days. It seems likely that improvements in patient care for sufferers of AIDS, as well as other factors, may well have contributed to these improvements in survival. However, the drug zidovudine is likely to be responsible for most of the improvement. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Evaluation, Patient outcomes, Mortality, Zidovudine

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Race, sex, drug use, and progression of human immunodeficiency virus disease

Article Abstract:

Survival rate and development of AIDS in people with HIV infection appear to be unrelated to sex, race, use of injected drugs, and level of income. For a median follow-up of 1.6 years, researchers followed 1,372 people with HIV infection who were treated at a single medical center. An increased risk of death was associated with a low CD4 cell count or AIDS diagnosis upon initial visit, and previous antiretroviral therapy. A decreased risk of death was associated with antiretroviral therapy and preventative therapy for pneumocystis after an initial visit. Lower mortality was also associated with having a job at the beginning of treatment. Progression of the disease to AIDS was associated with low CD4 count, older age, previous antiretroviral therapy, and disease symptoms on initial visit. Neither mortality nor development of AIDS were related to sex, race, drug use, or income. Prognosis may be more directly related to access to medical care than to biological differences among demographic groups.

Analysis, Development and progression, Demographic aspects, Health, Health and race, Ethnic groups

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Anemia and survival in HIV infection

Article Abstract:

Anemia in HIV infection appears to decrease survival, but treatment with erythropoietin may be effective. Anemia is a reduction in the concentration of red blood cells in the blood, which impairs oxygenation of tissues. Researchers studied the prognostic implications of anemia in 2,348 HIV patients at an urban clinic. In six years, 21% of patients developed mild or greater anemia, and 4% developed severe anemia. Survival decreased with progressively more-severe anemia. Erythropoietin treatment, which stimulates red cell production, was associated with improved survival.

Health aspects, Anemia, Prognosis, Drug therapy, Erythropoietin, Recombinant, Recombinant erythropoietin

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