AIDS. 1992 Jul;6(7):671-7.

Natural history of advanced HIV disease in patients treated with zidovudine. The Zidovudine Epidemiology Study Group.

AIDS (London, England)

R D Moore, J Keruly, D D Richman, T Creagh-Kirk, R E Chaisson

PMID: 1503686

Abstract

OBJECTIVE: To describe the natural history of advanced HIV disease in patients treated with zidovudine.

DESIGN: Longitudinal, observational study.

SETTING: Twelve academic and community-based sites.

PATIENTS, PARTICIPANTS: Eight hundred and sixty-three patients with AIDS or AIDS-related complex (ARC) with a CD4+ lymphocyte count less than 250 x 10(6)/l, who first received zidovudine between 15 April 1987 and 14 April 1988.

MAIN OUTCOME MEASURES: Survival, progression to AIDS and first development of specific opportunistic illness.

RESULTS: Median survival after initiation of zidovudine therapy ranged from greater than 900 days in patients with a baseline CD4+ lymphocyte count greater than or equal to 150 x 10(6)/l to 560 days in patients with a CD4+ lymphocyte count less than 50 x 10(6)/1. Other factors associated significantly with poorer survival were diagnosis of AIDS (versus ARC), baseline age greater than or equal to 40 years, hematocrit less than 35%, and diminished functional status. In patients with ARC at enrollment, median time of progression to AIDS ranged from 810 days in patients with a CD4+ lymphocyte count greater than or equal to 150 x 10(6)/l to 310 days in patients with a CD4+ lymphocyte count less than 50 x 10(6)/l. Rates of development of specific opportunistic infections or neoplasms and HIV encephalopathy were determined for different baseline CD4+ lymphocyte count ranges. Myelosuppression was significantly more common in patients with CD4+ lymphocyte counts greater than or equal to 100 x 10(6)/l. Sixty-five per cent of patients with a CD4+ lymphocyte count greater than or equal to 100 x 10(6)/l and 51% with a CD4+ lymphocyte count less than 100 x 10(6)/l continued to receive zidovudine 2 years after starting therapy.

CONCLUSIONS: We describe the natural history of a cohort of patients treated with zidovudine for advanced HIV disease. These CD4+ lymphocyte count-stratified estimates of disease progression should provide prognostic information useful in the clinical management of advanced disease and the design of future studies.

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Substances

• Zidovudine

MeSH terms

• AIDS-Related Complex / drug therapy
• AIDS-Related Complex / epidemiology
• AIDS-Related Complex / etiology
• Acquired Immunodeficiency Syndrome / drug therapy
• Acquired Immunodeficiency Syndrome / epidemiology
• Acquired Immunodeficiency Syndrome / etiology
• Adult
• Female
• HIV Infections / drug therapy
• HIV Infections / epidemiology
• HIV Infections / etiology
• Humans
• Longitudinal Studies
• Male
• Middle Aged
• Multicenter Studies as Topic
• Prospective Studies
• United States / epidemiology
• Zidovudine / therapeutic use

Publication Types

• Journal Article
• Research Support, Non-U.S. Gov't

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