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AIDS Patient Care STDS ; 12(2): 125-9, 1998 Feb.
Article in English | MEDLINE | ID: mdl-11361906


The purpose of this study was to describe the clinical profile of end-stage AIDS in patients 12 months before death. A cross-sectional examination of HIV-infected patients who attended a public HIV outpatient clinic between 1990 and 1996 and who died was conducted. The prevalence and first-time acquisition of AIDS-defining conditions 12 months before death were evaluated. The AIDS-defining conditions with the highest percentages of first-time acquisition in the last 12 months of life were progressive multifocal leukoencephalopathy (100%), lymphoma (96%), dementia (78.6%), Mycobacterium avium complex (MAC) infection (74.0%), toxoplasmosis (72.6%), and cytomegalovirus (CMV) infection (69.6%). Of the concomitant conditions studied, those with the highest percentages of first-time acquisition in the last 12 months of life were CMV with MAC (99%) and CMV with wasting (88%). Patients who acquire these AIDS-defining conditions may be eligible to receive information about end-stage options, such as hospice care. However, administration of aggressive antiretroviral treatments, such as the protease inhibitors, may affect this profile in the future, as the majority of the patients in this study were receiving the standard antiretroviral treatments of the time, primarily zidovudine.

AIDS-Related Opportunistic Infections/epidemiology , Acquired Immunodeficiency Syndrome/epidemiology , AIDS-Related Opportunistic Infections/therapy , Acquired Immunodeficiency Syndrome/therapy , Adolescent , Adult , Ambulatory Care , Cross-Sectional Studies , Disease Progression , Female , Humans , Louisiana/epidemiology , Male , Middle Aged , Prevalence , Risk Factors , Severity of Illness Index , Survival Rate
South Med J ; 94(4): 397-400, 2001 Apr.
Article in English | MEDLINE | ID: mdl-11332905


BACKGROUND: The proportion of older individuals infected with the human immunodeficiency virus (HIV) is rising. METHODS: We performed a retrospective case-control study of 58 patients more than 60 years old at the time of diagnosis of HIV infection and compared them with 232 controls (matched by CD4+ lymphocyte count). Clinical and demographic data were obtained from the Adult Spectrum of Diseases (ASD) database at the Medical Center of Louisiana. RESULTS: Patients in the older age group were more likely to be male and African American or Hispanic. The most common risk factor for acquisition of HIV infection among the patients was homosexual contact (53%). Disease staging was similar in both groups as determined by CD4+ lymphocyte counts and history of opportunistic infections. There was no difference in the use of antiretroviral therapy. In a Cox proportional hazard model and regression models, age > or = 60 years was associated with shorter survival. CONCLUSION: Patients who are older than 60 years at the time of diagnosis of HIV infection have a shorter survival than younger patients.

HIV Infections/diagnosis , HIV Infections/epidemiology , Age Distribution , Aged , Analysis of Variance , Anti-HIV Agents/therapeutic use , CD4 Lymphocyte Count , Comorbidity , Disease Progression , Female , HIV Infections/classification , HIV Infections/drug therapy , HIV Infections/immunology , Homosexuality/statistics & numerical data , Humans , Louisiana/epidemiology , Male , Middle Aged , Proportional Hazards Models , Retrospective Studies , Risk Factors , Severity of Illness Index , Survival Analysis
J Clin Microbiol ; 37(10): 3421-2, 1999 Oct.
Article in English | MEDLINE | ID: mdl-10488225


A chart review of 73 human immunodeficiency virus (HIV)-infected patients with enteric microsporidiosis was conducted to define the natural history of microsporidiosis. A substantial proportion of patients remained symptomatic after 6 months (54.8% with persistent diarrhea and 51.2% with weight loss). Predictors for persistent diarrhea included high HIV RNA viral load and no initiation of protease inhibitor therapy.

AIDS-Related Opportunistic Infections/complications , Intestinal Diseases, Parasitic/complications , Microsporida , Microsporidiosis/complications , Adult , Animals , Diarrhea/etiology , Female , Humans , Male , Middle Aged , Retrospective Studies , Weight Loss