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Survival Trends in Adolescents With Human Immunodeficiency Virus Infection

Survival Trends in Adolescents With Human Immunodeficiency Virus Infection Abstract Objective: To examine trends in survival and death in nonhemophiliac adolescents with human immunodeficiency virus (HIV) infection. Design: Case series. Subjects: All 117 HIV-seropositive adolescents (age range, 13 to 21 years) without hemophilia whose cases were reported through December 1992. Setting: A state with mandatory, name-linked reporting of cases of HIV. Methods: Review of death certificates and public records, and interviews with subjects and key informants. Analyses: Kaplan-Meier and Cox proportional hazards regression analyses of time from the diagnosis of HIV infection to death. Results: Documentation of death or survival was available for 92% (108/117) of the sample. Fourteen percent (15/108) of the subjects were known to have died, mainly of well-recognized complications of acquired immunodeficiency syndrome. Among deceased subjects, the median duration of survival after the diagnosis of HIV was 3 years. Cumulative survival at 8 years after the diagnosis was 52%, with 4 years being the median period of observation (range, <1 year to 8 years). Stratification of survival functions by gender, race, and mode of transmission revealed no significant (P<.05) differences between groups. However, advancing age at the time of the diagnosis was inversely associated with survival. Conclusions: Despite an apparent advantage to young age, overall survival in this adolescent cohort was shorter than expected. Rather than an inherently rapid progression of disease during adolescence, delays in diagnosis and treatment might better explain the results.(Arch Pediatr Adolesc Med. 1995;149:1093-1096) References 1. Goedert JJ, Kessler CM, Aledort LM, et al. A prospective study of human immunodeficiency virus type 1 infection and the development of AIDS in subjects with hemophilia . N Engl J Med . 1989;321:1141-1148.Crossref 2. Futterman D, Hein K, Reuben N, Dell R, Shaffer N. Human immunodeficiency virus–infected adolescents: the first 50 patients in a New York City program . Pediatrics . 1993;91:730-735. 3. Belzer M, Marcus B. The medical course of HIV infection in youth . J Adolesc Health . 1994;15:94.Crossref 4. Lemp GF, Payne SF, Neal D, Temelso T, Rutherford GW. Survival trends for patients with AIDS . JAMA . 1990;263:402-406.Crossref 5. Miller HG, Turner CF, Moses LE, eds. AIDS: The Second Decade . Washington, DC: National Academy Press; 1990. 6. Centers for Disease Control and Prevention. HIV/AIDS Surveillance Report . Atlanta, Ga: Centers for Disease Control and Prevention; 1993;5:1-19. 7. Ward JW, Bush TJ, Perkins HA, et al. The natural history of transfusion-associated infection with human immunodeficiency virus: factors influencing rate of progression to disease . N Engl J Med . 1989;321:947-957.Crossref 8. Friedland GH, Saltzman B, Vileno J, Freeman K, Schrager LK, Klein RS. Survival differences in patients with AIDS . J Acquir Immune Defic Syndr . 1991; 4:144-153. 9. Rothenberg R, Woelfel M, Stoneburner R, Milberg J, Parker R, Truman B. Survival with the acquired immunodeficiency syndrome: experience with 5833 cases in New York City . N Engl J Med . 1987;317:1297-1302.Crossref 10. Rutherford GW, Lifson AR, Hessol NA, et al. Course of HIV-1 infection in a cohort of homosexual and bisexual men: an 11-year follow-up study . BMJ . 1990;301:1183-1188.Crossref 11. McGrady GA, Jason JM, Evatt BL. The course of the epidemic of acquired immunodeficiency syndrome in the United States hemophilia population . Am J Epidemiol . 1990;322:166-172. 12. Swanson CE, Cooper DA. Factors influencing outcome of treatment with zidovudine of patients with AIDS in Australia . AIDS . 1990;4:749-757.Crossref 13. Gayle HD, D'Angelo LJ. Epidemiology of acquired immunodeficiency syndrome and human immunodeficiency virus infection in adolescents . Pediatr Infect Dis J . 1991;10:322-328.Crossref 14. Marzuk PM, Tierney H, Tardiff K, et al. Increased risk of suicide in persons with AIDS . JAMA . 1988;259:1333-1337.Crossref 15. Remafedi G. Predictors of unprotected intercourse among gay and bisexual youth: knowledge, beliefs, and behavior . Pediatrics . 1994;94:163-168. 16. Futterman D, Rogers A, D'Angelo L, Levin L. Transmission dynamics and clinical status of HIV+ youth . J Adolesc Health . 1995:16:134. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Pediatrics & Adolescent Medicine American Medical Association

Survival Trends in Adolescents With Human Immunodeficiency Virus Infection

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References (16)

Publisher
American Medical Association
Copyright
Copyright © 1995 American Medical Association. All Rights Reserved.
ISSN
1072-4710
eISSN
1538-3628
DOI
10.1001/archpedi.1995.02170230047006
Publisher site
See Article on Publisher Site

Abstract

Abstract Objective: To examine trends in survival and death in nonhemophiliac adolescents with human immunodeficiency virus (HIV) infection. Design: Case series. Subjects: All 117 HIV-seropositive adolescents (age range, 13 to 21 years) without hemophilia whose cases were reported through December 1992. Setting: A state with mandatory, name-linked reporting of cases of HIV. Methods: Review of death certificates and public records, and interviews with subjects and key informants. Analyses: Kaplan-Meier and Cox proportional hazards regression analyses of time from the diagnosis of HIV infection to death. Results: Documentation of death or survival was available for 92% (108/117) of the sample. Fourteen percent (15/108) of the subjects were known to have died, mainly of well-recognized complications of acquired immunodeficiency syndrome. Among deceased subjects, the median duration of survival after the diagnosis of HIV was 3 years. Cumulative survival at 8 years after the diagnosis was 52%, with 4 years being the median period of observation (range, <1 year to 8 years). Stratification of survival functions by gender, race, and mode of transmission revealed no significant (P<.05) differences between groups. However, advancing age at the time of the diagnosis was inversely associated with survival. Conclusions: Despite an apparent advantage to young age, overall survival in this adolescent cohort was shorter than expected. Rather than an inherently rapid progression of disease during adolescence, delays in diagnosis and treatment might better explain the results.(Arch Pediatr Adolesc Med. 1995;149:1093-1096) References 1. Goedert JJ, Kessler CM, Aledort LM, et al. A prospective study of human immunodeficiency virus type 1 infection and the development of AIDS in subjects with hemophilia . N Engl J Med . 1989;321:1141-1148.Crossref 2. Futterman D, Hein K, Reuben N, Dell R, Shaffer N. Human immunodeficiency virus–infected adolescents: the first 50 patients in a New York City program . Pediatrics . 1993;91:730-735. 3. Belzer M, Marcus B. The medical course of HIV infection in youth . J Adolesc Health . 1994;15:94.Crossref 4. Lemp GF, Payne SF, Neal D, Temelso T, Rutherford GW. Survival trends for patients with AIDS . JAMA . 1990;263:402-406.Crossref 5. Miller HG, Turner CF, Moses LE, eds. AIDS: The Second Decade . Washington, DC: National Academy Press; 1990. 6. Centers for Disease Control and Prevention. HIV/AIDS Surveillance Report . Atlanta, Ga: Centers for Disease Control and Prevention; 1993;5:1-19. 7. Ward JW, Bush TJ, Perkins HA, et al. The natural history of transfusion-associated infection with human immunodeficiency virus: factors influencing rate of progression to disease . N Engl J Med . 1989;321:947-957.Crossref 8. Friedland GH, Saltzman B, Vileno J, Freeman K, Schrager LK, Klein RS. Survival differences in patients with AIDS . J Acquir Immune Defic Syndr . 1991; 4:144-153. 9. Rothenberg R, Woelfel M, Stoneburner R, Milberg J, Parker R, Truman B. Survival with the acquired immunodeficiency syndrome: experience with 5833 cases in New York City . N Engl J Med . 1987;317:1297-1302.Crossref 10. Rutherford GW, Lifson AR, Hessol NA, et al. Course of HIV-1 infection in a cohort of homosexual and bisexual men: an 11-year follow-up study . BMJ . 1990;301:1183-1188.Crossref 11. McGrady GA, Jason JM, Evatt BL. The course of the epidemic of acquired immunodeficiency syndrome in the United States hemophilia population . Am J Epidemiol . 1990;322:166-172. 12. Swanson CE, Cooper DA. Factors influencing outcome of treatment with zidovudine of patients with AIDS in Australia . AIDS . 1990;4:749-757.Crossref 13. Gayle HD, D'Angelo LJ. Epidemiology of acquired immunodeficiency syndrome and human immunodeficiency virus infection in adolescents . Pediatr Infect Dis J . 1991;10:322-328.Crossref 14. Marzuk PM, Tierney H, Tardiff K, et al. Increased risk of suicide in persons with AIDS . JAMA . 1988;259:1333-1337.Crossref 15. Remafedi G. Predictors of unprotected intercourse among gay and bisexual youth: knowledge, beliefs, and behavior . Pediatrics . 1994;94:163-168. 16. Futterman D, Rogers A, D'Angelo L, Levin L. Transmission dynamics and clinical status of HIV+ youth . J Adolesc Health . 1995:16:134.

Journal

Archives of Pediatrics & Adolescent Medicine – American Medical Association

Published: Oct 1, 1995

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