• Login
    View Item 
    •   JScholarship Home
    • Biostatistics, Dept. of
    • Faculty Research
    • View Item
    •   JScholarship Home
    • Biostatistics, Dept. of
    • Faculty Research
    • View Item
    JavaScript is disabled for your browser. Some features of this site may not work without it.

    The effects on survival of early treatment of human immunodeficiency virus infection.

    Thumbnail
    View/Open
    1992 - The effects on survival of early treatment of human immunodeficiency virus infection.pdf (1.192Mb)
    Date
    1992-04-16
    Author
    Graham, Neil M. H.
    Detels, Roger
    Zeger, Scott L.
    Park, Lawrence P.
    Vermund, Sten H.
    Phair, John P.
    Rinaldo, Charles R.
    Metadata
    Show full item record
    Abstract
    BACKGROUND. Zidovudine has been shown to prolong survival in patients with the acquired immunodeficiency syndrome (AIDS) and, in persons with human immunodeficiency virus (HIV) infection but not AIDS, to delay the progression to AIDS. However, it is still uncertain whether treatment before the development of AIDS prolongs survival. METHODS. We analyzed data from a cohort of 2162 high-risk men who were already seropositive for HIV type 1 (HIV-1) and 406 men who seroconverted from October 1986 through April 1991. There were 306 deaths. The probabilities of death were compared among men at similar stages of disease who began zidovudine therapy before the diagnosis of AIDS and among those who did not. Relative risks of death were calculated for each of five initial disease states on the basis of CD4+ cell counts and clinical symptoms and signs appearing over follow-up periods of 6, 12, 18, and 24 months. Adjustments were also made for the use of prophylaxis against Pneumocystis carinii pneumonia (PCP). RESULTS. After we controlled for CD4+ cell count and symptoms, the use of zidovudine with or without PCP prophylaxis before the development of AIDS significantly reduced mortality in all follow-up periods. The relative risks of death were 0.43 (95 percent confidence interval, 0.23 to 0.78) at 6 months, 0.54 (95 percent confidence interval, 0.38 to 0.78) at 12 months, 0.59 (95 percent confidence interval, 0.44 to 0.79) at 18 months, and 0.67 (95 percent confidence interval, 0.52 to 0.86) at 24 months. After we adjusted for the effects of PCP prophylaxis, zidovudine alone significantly reduced mortality at 6, 12, and 18 months (relative risks, 0.45, 0.59, and 0.70, respectively), but not at 24 months (relative risk, 0.81). Among zidovudine users, those who also used PCP prophylaxis before the development of AIDS had significantly lower mortality at 18 and 24 months than those who did not (relative risks, 0.62 and 0.60, respectively). CONCLUSIONS. The results of this study support the hypothesis that in HIV-1 infection, early treatment with zidovudine and PCP prophylaxis improves survival in addition to slowing the progression to AIDS.
    URI
    http://jhir.library.jhu.edu/handle/1774.2/32830
    Collections
    • Faculty Research

    DSpace software copyright © 2002-2016  DuraSpace
    Policies | Contact Us | Send Feedback
    Theme by 
    Atmire NV
     

     

    Browse

    All of JScholarshipCommunities & CollectionsBy Issue DateAuthorsTitlesSubjectsThis CollectionBy Issue DateAuthorsTitlesSubjects

    My Account

    LoginRegister

    DSpace software copyright © 2002-2016  DuraSpace
    Policies | Contact Us | Send Feedback
    Theme by 
    Atmire NV