CME: Examining AIDS-Defining Opportunistic Infections

CME: Examining AIDS-Defining Opportunistic Infections

Studies have shown that AIDS-defining opportunistic infection (AIDS-OIs) were a leading cause of mortality and morbidity among patients with HIV prior to the advent of antiretroviral therapy (ART) in 1997. Despite substantial improvements in the treatment of HIV and OIs during the last 2 decades, data indicate that OIs remain a major contributor of HIV-related morbidity and mortality. Previous research has provided unclear results regarding the outcomes of HIV patients with OIs, and few were population-based. Recent estimates of survival following an AIDS-OI in the United States are lacking.   OI Survival Analysis To examine whether survival following an OI has improved with advancements in HIV treatment, John T. Brooks, MD, and colleagues had a study published in the Journal of Infectious Diseases. The authors used HIV surveillance data to estimate survival probabilities after a first OI diagnosis among adults with AIDS in San Francisco during three treatment eras: 1981-1986, 1987-1996, and 1997-2012. “Most patients meet the AIDS criteria from a national surveillance perspective based on their CD4 cell count,” explains Dr. Brooks, “but the San Francisco Department of Public Health has continuously monitored the clinical courses of all people infected with AIDS in the city, including survival after an OI.” The health department has collected data on initial and subsequent OIs—as well as CD4 cell counts, viral loads, immunizations received—and demographic information for nearly 21,000 patients through follow-ups approximately every 18 to 24 months. “We found that survival has markedly increased following an AIDS-OI since 1981,” says Dr. Brooks (Figure). “The 5-year survival probability increased from 7% in 1981-1986 to 65% in 1997-2012.” The researchers suspect that this...
Examining AIDS-Defining Opportunistic Infections

Examining AIDS-Defining Opportunistic Infections

Studies have shown that AIDS-defining opportunistic infection (AIDS-OIs) were a leading cause of mortality and morbidity among patients with HIV prior to the advent of antiretroviral therapy (ART) in 1997. Despite substantial improvements in the treatment of HIV and OIs during the last 2 decades, data indicate that OIs remain a major contributor of HIV-related morbidity and mortality. Previous research has provided unclear results regarding the outcomes of HIV patients with OIs, and few were population-based. Recent estimates of survival following an AIDS-OI in the United States are lacking.   OI Survival Analysis To examine whether survival following an OI has improved with advancements in HIV treatment, John T. Brooks, MD, and colleagues had a study published in the Journal of Infectious Diseases. The authors used HIV surveillance data to estimate survival probabilities after a first OI diagnosis among adults with AIDS in San Francisco during three treatment eras: 1981-1986, 1987-1996, and 1997-2012. “Most patients meet the AIDS criteria from a national surveillance perspective based on their CD4 cell count,” explains Dr. Brooks, “but the San Francisco Department of Public Health has continuously monitored the clinical courses of all people infected with AIDS in the city, including survival after an OI.” The health department has collected data on initial and subsequent OIs—as well as CD4 cell counts, viral loads, immunizations received—and demographic information for nearly 21,000 patients through follow-ups approximately every 18 to 24 months. “We found that survival has markedly increased following an AIDS-OI since 1981,” says Dr. Brooks (Figure). “The 5-year survival probability increased from 7% in 1981-1986 to 65% in 1997-2012.” The researchers suspect that this...