NEW YORK, Feb 07 (Reuters) -- Patients with AIDS are now more likely to survive their first AIDS-defining illness, but the long-term survival after diagnosis with AIDS remains poor. according to a report in the British Medical Journal.
A study in England of more than 2,600 people with AIDS who attended two clinics between 1981 and 1995 found that about 22% to 24% survived three years after AIDS diagnosis.
Average survival time after AIDS diagnosis is 20 months, and only 1 in 15 patients is alive five years after diagnosis of full-blown AIDS.
"There has been little change in prognosis since 1987," say members of collaborative AIDS study group based at the Royal Free Hospital School of Medicine in London.
But the researchers note the three-year survival figures are higher by up to eight percentage points compared with several previous studies of AIDS patients across Europe, and are closer to findings in the U.S.
In addition, the authors point out that survival in the first three months after diagnosis of an AIDS-defining illness (signifying full-blown AIDS) was about 56% better for those who were diagnosed after 1987.
The three-month survival figures appear to be dependent on the nature of the illness that leads to AIDS diagnosis.
"When the diagnosis (of AIDS) was based on esophageal candidiasis or Kaposi's sarcoma, patients had a lower risk of death than when the diagnosis was based on Pneumocystis carinii pneumonia," they say.
Specifically, the chances of surviving three months was about 80% better among those with esophageal candida and about 63% better for those with Kaposi's sarcoma when compared with patients with Pneumocystis pneumonia.
The authors say their findings show that advances in AIDS treatment have made a difference. "Patients whose diagnosis was made in later years (after 1987) had a significantly lower risk of death, and this may be due to improvements in treating the initial AIDS-defining illness... (in 1987) almost 12% of patients died within a month of their initial AIDS diagnosis, this compares with 3.3% in our patients in whom AIDS was diagnosed after 1987."
But the long-term outlook for AIDS patients is poor, according to the British researchers. "AIDS is now being diagnosed later and patients are more immunocompromised when AIDS is diagnosed," conclude the authors.
SOURCE: British Medical Journal (1997;314:9-13)
