Marked improvement in survival among adult Croatian AIDS patients after the introduction of highly active antiretroviral treatment

Begovac, Josip and Lisić, Miroslav and Lukas, Davorka and Maretić, Tomislav and Kniewald, Tihana and Nowotny, Thomas E. (2006) Marked improvement in survival among adult Croatian AIDS patients after the introduction of highly active antiretroviral treatment. Collegium Antropologicum, 30 (1). pp. 175-179. ISSN 0350-6134

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Abstract

We compared the survival of patients following the first AIDS event in Croatia from the period 1986-1996 to the period 1997-2000. A total of 72 (81.8%) out of 88 patients from 1986-1996 and 18 (32.1%) out of 56 from 1997-2000 died. Survival following the first AIDS-defining illness markedly improved in the period 1997-2000 compared to the period 1986-1996 (adjusted Hazard Ratio (HR) for patients surviving more than 6 months: 0.11, 95% confidence interval (95% CI) = 0.04-0.29). A CD4+ cell count of < 100 x 10(6)/L was an independent risk factor for patients surviving up to 2 years (adjusted HR = 1.96, 95% CI = 1.1-3.43, p = 0.02). Patients with tuberculosis or fungal infections had a longer survival when compared to other diagnosis (adjusted HR = 0.53, 95% CI = 0.32-0.90, p = 0.01). However, despite dramatic survival benefit of combination antiretroviral therapy, mortality at six months following the first AIDS event was similar in the two study periods and the one-year probability of death was still substantial (27.2%) in the period 1997-2000.

Abstract in Croatian

Usporedili smo preživljavanje bolesnika nakon dijagnoze AIDS-a u Hrvatskoj u razdoblju 1986–1996. g. s razdobljem 1997– 2000. g. 72 (81,8%) od 88 bolesnika iz 1986–1996. g. i 18 (32,1%) od 56 iz 1997–2000. g. je umrlo. Preživljavanje nakon prve AIDS-definirajuće bolesti se značajno poboljšalo u razdoblju 1997–2000 u odnosu na razdoblje 1986–1996 (prilagođeni omjer hazarda (HR) za bolesnike koji su preživjeli više od 6 mjeseci: 0,11, 95% CI: 0,04–0,29). Broj CD4+ limfocita < 100 x 10na6/L je također bio neovisni čimbenik preživljavanja za bolesnike koji su preživjeli 2 godine (prilagođeni HR=1,96, 95%CI=1,1–3,43, p=0,02). Bolesnici s tuberkulozom ili gljivičnom infekcijom imali su bolje preživljavanje u usporedbi s drugim dijagnozama (prilagođeni HR=0,53, 95%CI=0,32–0,90, p=0,01). Međutim, usprkos izrazito boljem preživljavanju zbog kombinirane antiretrovirusne terapije, smrtnost 6 mjeseci od AIDS-a je bila slična u oba razdoblja, a smrtnost nakon jedne godine od AIDS-a je bila još uvijek značajna (27,2%) u razdoblju 1997–2000.

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