Survival with AIDS in Ireland

Abstract

To analyse the pattern of survival for patients diagnosed with AIDS in Dublin. Data on 193 patients visiting the Department of Genitourinary Medicine of a Dublin Hospital, over a period of 7 years with AIDS, were analysed, and survival patterns were investigated. The cumulative probability of survival for the cohort was 69.0 ± 3.3% at 1 year and 6.5 ± 2.5% at 5 years. Median survival was 576 days. Year of diagnosis and disease group to which the patient belonged at diagnosis had a significant influence on the survival of the cohort (P < 0.0006 and P < 0.02, respectively). Age group, disease group, and year of diagnosis showed significant differences between strata (P < 0.01, P < 0.002, and P < 0.04, respectively). Patients aged 35–39 years showed longer median survival times (715 days) than all other age groups (median survival = 547 days; P < 0.04). Patients whose disease group at diagnosis was opportunistic disease(s) alone (Centers for Disease Control 1987 criteria, stage IV group C1) had a significantly longer median survival (672 days) than all others (median survival 281 days; P < 0.0002). Survival did not differ significantly by sex or risk group alone, nor did it differ significantly by manifestation of disease when grouped according to recognised criteria. Treatment with antiretroviral therapy had a significant influence on the survival of the cohort (P < 0.0002), and the treatment group showed a significant difference between strata (P < 0.0002). This result must be qualified by the fact that, first, 11 of the 26 patients not receiving therapy died within 1 month of diagnosis and people who survived longer had a greater chance of beginning treatment, and that, secondly, criteria for antiretroviral therapy allocation were not entirely clear. The overall survival time found by this study is comparable to that found in other studies in developed countries of the survival of persons with AIDS. Patterns of survival for age groups and manifestation of disease show some contrasting features, mainly owing to the demographic profile of the patients and the high proportion of intravenous drug users.