Factors associated with the time elapsed between the initial detection of HIV-1 antibodies and a diagnosis of AIDS among patients followed in Lyons University Hospitals

Abstract

Objective: To identify the factors associated with a short period between the initial detection of HIV-1 antibodies and AIDS diagnosis among patients from Lyons, France. Design and method: Prospective hospital based cohort study of patients diagnosed with AIDS in Lyons University Hospitals from 1994 to 1997. Cox regression was used to identify the variables independently associated with a short period between the first positive HIV-1 detection test and AIDS. Results: 466 patients were studied, the mean period between the detection of HIV-1 antibodies and AIDS was 48 months and did not change across calendar years. Age <46 years (hazard ratio (HR) 0.77, 95% confidence interval (CI) 0.58-1.00), HIV-1 transmission by heterosexual contact (HR 1.93, 95% CI 1.49-2.51), Pneumocystis carinii pneumonia (HR 1.67, 95% CI 1.28-2.17), or Kaposi's sarcoma (HR 1.42, 95% CI 1.06-1.90) as the first AIDS defining event, and CD4+ count <100x103/ml (HR 1.25, 95% CI 1.02- 1.55) were associated with a short time interval between detection of HIV-1 antibodies and AIDS. Conclusion: Educational interventions focused on heterosexuals and those aged over 45 are needed to promote the early detection of HIV infection, in the hope of reducing transmission and improving individual prognosis.