Natural history of advanced HIV disease in patients treated with zidovudine

Richard D Moore, Jeanne C Keruly, Douglas D. Richman, Terri Creagh-Kirk, Richard E Chaisson

Research output: Contribution to journalArticle

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 6/I, 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 >900 days in patients with a baseline CD4+ lymphocyte count ≥150 × 106/I to 560 days in patients with a CD4+ lymphocyte count 6/1. Other factors associated significantly with poorer survival were diagnosis of AIDS (versus ARC), baseline age ≥40 years, hematocrit 6/I to 310 days in patients with a CD4+ lymphocyte count 6/I. 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 ≥100 × 106/I. Sixty-five per cent of patients with a CD4+ lymphocyte count ≥100 × 106/I and 51% with a CD4+ lymphocyte count 6/I 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.

Original languageEnglish (US)
Pages (from-to)671-677
Number of pages7
JournalAIDS
Volume6
Issue number7
StatePublished - Jul 1992

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Zidovudine
CD4 Lymphocyte Count
Natural History
HIV
AIDS-Related Complex
Acquired Immunodeficiency Syndrome
Survival
AIDS Dementia Complex
Opportunistic Infections
Disease Management
Hematocrit
Observational Studies
Longitudinal Studies
Disease Progression
Outcome Assessment (Health Care)
Therapeutics

Keywords

  • Epidemiology
  • Natural history
  • Opportunistic infection
  • Zidovudine

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

Cite this

Natural history of advanced HIV disease in patients treated with zidovudine. / Moore, Richard D; Keruly, Jeanne C; Richman, Douglas D.; Creagh-Kirk, Terri; Chaisson, Richard E.

In: AIDS, Vol. 6, No. 7, 07.1992, p. 671-677.

Research output: Contribution to journalArticle

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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 6/I, 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 >900 days in patients with a baseline CD4+ lymphocyte count ≥150 × 106/I to 560 days in patients with a CD4+ lymphocyte count 6/1. Other factors associated significantly with poorer survival were diagnosis of AIDS (versus ARC), baseline age ≥40 years, hematocrit 6/I to 310 days in patients with a CD4+ lymphocyte count 6/I. 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 ≥100 × 106/I. Sixty-five per cent of patients with a CD4+ lymphocyte count ≥100 × 106/I and 51{\%} with a CD4+ lymphocyte count 6/I 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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