A new study being published in the September 21, 1995, issue of The New England Journal of Medicine examines the relationships of race, sex, and drug use to progression of HIV disease. The rates of progression of HIV infection and survival have been reported in a number of earlier studies to differ between sociodemographic groups, though it has remained unclear whether these differences reflected biologic differences or differences in access to medical care.
The researchers concluded that among patients with HIV infection who received medical care from a single urban center, there were no differences in disease progression or survival associated with sex, race, injection-drug use, or socioeconomic status. Differences found in other studies may reflect differences in the use of medical care.
Researchers at The Johns Hopkins University School of Medicine in Baltimore, supported by an AHCPR research grant, measured disease progression and survival in a cohort of 1,372 patients who were seropositive for HIV, and who were treated at a single urban center. Median follow-up was 1.6 years. They calculated the rates of survival for the entire cohort and the rates of progression to the acquired immunodeficiency syndrome (AIDS) or death in 740 patients who presented without AIDS.
In the entire cohort, a lower CD4 cell count, a diagnosis of AIDS, older age, and the receipt of antiretroviral therapy before enrollment were associated with an increased risk of death. The use of prophylaxis against pneumocystis pneumonia, zidovudine use after enrollment, and having a job at base line were associated with lower risks of death. The researchers found no significant difference in survival between men and women, blacks and whites, injection-drug users and those who did not use drugs, or patients whose median annual incomes were $5,000 or less and those whose incomes were more than $5,000. They found no relation between disease progression and sex, race, injection-drug use, income, level of education, or insurance status.
Note: The article in the September 21, 1995 issue of The New England Journal of Medicine is entitled "Race, Sex, Drug Use, and Progression of Human Immunodeficiency Virus Disease," by Richard E. Chaisson, MD, Jeanne C. Keruly, BSN, and Richard D. Moore, MD, MHSc.
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