Effect of anti-retroviral therapy and prophylaxis against opportunistic diseases on survival of patients with AIDS

Objective. To analyze the influence of anti-retroviral therapy (ART) and prophylaxis against opportunist disease on survival of patients with AIDS. Patients and methods. Study of AIDS patients diagnosed from January 1996 to October 1997 in a Madrid hospital. An analysis was made of demographic, clinical, and immunological data, as well as ART and prophylaxis against Pneumocystis carinii pneumonia (PCP) and tuberculosis (TB). Both univariate and multivariate analyses were performed, as well as Kaplan-Meier curves. Results. A total of 205 patients were included in the study (83% male) with a median age of 34 years. ART, PCP prophylaxis, and TB prophylaxis were received by 147 (72%), 141 (69%) and 22 (11%) patients, respectively. Among individuals on ART, the likelihood of survival at 12 and 22 months since diagnosis of AIDS was made was 79% and 76%, respectively, and among non treated individuals 54% and 54%, respectively (p < 0.05). ART was associated with a 57% decrease in death risk, and regarding PCP prophylaxis, no benefit on survival was found. Conclusions. ART was significantly associated with a lower risk of death among AIDS patients. The survival rate was not increased with PCP prophylaxis.