Factors influencing survival after AIDS: report from the Multicenter AIDS Cohort Study (MACS).
Factors influencing survival after AIDS: report from the Multicenter AIDS Cohort Study (MACS).
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发表时间：
1994-03
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通讯作者：
A. Saah;D. Hoover;Yanhua He;Kingsley La;Phair Jp
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作者：
A. Saah;D. Hoover;Yanhua He;Kingsley La;Phair Jp
本研究的目的是确定临床体征、症状、实验室变量和治疗或预防药物的使用是否与临床AIDS诊断后的生存率有预后相关性。共有2，168名人类免疫缺陷病毒1型（HIV-1）血清阳性的同性恋男性参加了一项纵向队列研究，研究地点包括巴尔的摩、马里兰州、华盛顿，华盛顿特区，美国伊利诺斯州的芝加哥、宾夕法尼亚州的匹兹堡和加州的洛杉矶--多中心艾滋病队列研究（MACS）艾滋病诊断前6个月内的变量包括年龄、CD 4+淋巴细胞计数、血红蛋白和自我报告的鹅口疮、发热、艾滋病发作前开始的抗逆转录病毒治疗（ART）和艾滋病后开始的ART（作为时间依赖性协变量），作为互斥类别进行分析，卡氏肺孢子虫肺炎（PCP）的预防也是如此。拟合了从艾滋病到死亡时间的单变量和多变量生存模型。在单因素分析中，艾滋病发病前年龄较小、CD 4+淋巴细胞、血红蛋白计数较高、无鹅口疮或发热与艾滋病后生存期较长相关。那些在艾滋病发作后3个月内开始抗逆转录病毒治疗的人，从艾滋病后3个月开始，与那些在艾滋病之前开始抗逆转录病毒治疗的人（1.18年）相比，中位生存期更长（1.75年）。这种比较不受偏见的影响，即那些谁生存时间更长有更大的可能性，随后接受ART。预防PCP艾滋病发病后开始也与艾滋病后生存时间较长时，与艾滋病前开始预防或从未使用预防。（250字处删节）
The objective of this study was to determine if clinical signs, symptoms, laboratory variables, and use of therapeutic or prophylactic agents have prognostic associations with survival after diagnosis of clinical AIDS. A total of 2,168 homosexual men, seropositive for human immunodeficiency virus type 1 (HIV-1) participated in a longitudinal cohort study of the greater metropolitan areas of Baltimore, Maryland, Washington, D.C., Chicago, Illinois, Pittsburgh, Pennsylvania, and Los Angeles, California, U.S.A.--the Multicenter AIDS Cohort Study (MACS). Variables within 6 months prior to AIDS diagnosis included age, CD4+ lymphocyte counts, hemoglobin, and self-reported thrush, fever, anti-retroviral therapy (ART) beginning prior to AIDS onset, and ART beginning after AIDS (as a time-dependent covariate) were analyzed as mutually exclusive categories, as was prophylaxis for Pneumocystis carinii pneumonia (PCP). Univariate and multivariate survival models of time from AIDS to death were fit. In univariate analysis, younger age, higher counts of CD4+ lymphocytes, hemoglobin, and absence of thrush or fever prior to AIDS onset were associated with longer survival after AIDS. Those who began ART within 3 months after AIDS onset had longer median survival (1.75 years), from 3 months after AIDS, when compared with those who began ART prior to AIDS (1.18 years). This comparison is not influenced by the bias that those who survive longer have a greater likelihood to subsequently receive ART. Prophylaxis for PCP beginning after AIDS onset was also associated with longer post-AIDS survival when compared with beginning prophylaxis prior to AIDS or never using prophylaxis.(ABSTRACT TRUNCATED AT 250 WORDS)