Survival and Disease Progression According to Gender of Patients With HIV Infection

Melnick, Sandra; Sherer, Renslow; Louis, Thomas A.; Hillman, David W.; Rodriguez, Evelyn M.; Lackman, Cheryl; Capps, Linnea; Brown, Lawrence S.; Carlyn, Marcia; Korvick, Joyce A.; Deyton, Lawrence; Johns, Stanley; Ellison, Jacquelyn; Hickson, Micheal J.; Lee, Janet; Thompson, Melanie; Creagh, Terri; Morris, Amy; Ernst, J. A.; Pollard, Cathy L.; Anastos, Kathryn; Bar, Mordechai; Doramajian, Elizabeth; Blatt, D.W.E.; Moore, David; Renzetti, Renee; Verheggen, Rita; Luskin-Hawk, Roberta; Torres, Ramón A.; Townley, David; Clanon, Kathleen; Morris, Bea; Owen, William F.; Brosgart, Carol; Crane, Lawrence R.; Ebright, John R.; Schuman, Paula; Valuer, William; Fairclough, Colleen; Holloway, William J.; Winslow, Dean L.; Szabo, Susan; Bincsik, Arlene; Swanson, Karen R.; Cohn, David L.; Reves, Randall; Grodesky, Michael J.; Mesard, Carol A.; Gans, Joan E.; El‐Sadr, Wafaa; Guity, Cheryl; Hardy, Michelle; Fuentes, Luis G.; Saravolatz, Louis D.; Markowitz, Norman; Kumi, Jones O.; Mastro-Polak, Diane; Hutchinson, Jill; Walker, Janice; Pablovich, Sue; Simmons, P; Kimmel, Nancy; Kocher, Jeffrey; Weisholtz, Steven J.; Sheridan, Annemarie; Taylor, Victoria M.; Braithwaite, Jilleen; Sampson, James H.; Godbey, Joel; Loveless, Mark O.; Salveson, Catherine; Martínez, Norma Carro; Kerkering, Thomas M.; Webster, Carol; Fisher, Evelyn; Link, Kurt; Gernon, Lawrence; Labriola, Ami; Gibert, Cynthia L.; Scott, John; Finley, Elizabeth; Irvin, Karen; Neaton, James D.; Brelje, Tim; DuChene, Alain G.; Thompson, Greg; Wentworth, Deborah; Sanvffle, Jane; Foulkes, Mary A.

doi:10.1001/jama.1994.03520240043039

Cited by 138 publications

(33 citation statements)

References 29 publications

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“…In one study, women were found to have an increased risk Thus, while there was a significantly lower serum virus load of death but not of disease progression [6]. This may be attriband a wider distribution of serum virus load values in women, uted to the fact that women may have more limited access to the rate of change in virus load over the study period was health care and poorer socioeconomic status than men in the similar in men and women.…”

Section: Resultsmentioning

confidence: 97%

Serum Levels of Virus Burden in Early‐Stage Human Immunodeficiency Virus Type 1 Disease in Women

Evans

Nims²,

Cooley³

et al. 1997

J INFECT DIS

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The fundamental clinical, viral, and immunologic features of early-stage human immunodeficiency virus type 1 (HIV-1) disease were examined in a seroprevalent cohort of 28 men and 14 women assessed longitudinally at three equally dispersed time points over a mean of 43 months. There were no gender differences in the relative risk of developing AIDS-defining end points or death. The median serum RNA levels assessed at the three study time points were 3.3-, 4.9-, and 1.5-fold lower, respectively, in women than in men. This suggests that while serum virus load may be as powerful a correlate of disease status in women as it is in men, the absolute values of the virus levels may be different in the 2 populations. These observations may have implications for the interpretation of levels of virus burden in women for the assessment of disease progression, transmission, and treatment.

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Section: Resultsmentioning

confidence: 97%

Serum Levels of Virus Burden in Early‐Stage Human Immunodeficiency Virus Type 1 Disease in Women

Evans

Nims²,

Cooley³

et al. 1997

J INFECT DIS

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show abstract

“…[5][6][7][8][9] The reasons for a shorter survival in this group are thus still unclear and have been attributed to inequalities in access to health care or to HIV treatment. 10 The Brazilian epidemic is a good scenario to investigate potential gender differences in AIDS prognosis. Nowhere else in the world was the increase in reported female AIDS cases faster and more remarkable.…”

Section: Introductionmentioning

confidence: 99%

Gender Differences in Survival in an HIV/AIDS Cohort from São Paulo, Brazil

Braga

Cardoso

Segurado

2007

AIDS Patient Care and STDs

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Highly active antiretroviral therapy accounted for significant improvement in AIDS prognosis. However, in areas where access to antiretrovirals is universal, the impact of treatment might have been less remarkable among women. To compare survival between men and women living with HIV, we studied a retrospective cohort of 1072 patients who attended a Brazilian reference center. Time to AIDS-related death was the dependent variable. Medical charts were reviewed to obtain sociodemographic data, clinical, and laboratory outcomes. Cumulative survival probability was estimated by the Kaplan-Meier method and hazard ratios by Cox proportional hazards model. At admission, 55% of men and 38% of women had AIDS. Ninety-one AIDS-related deaths occurred in 6004 person-years of follow-up (PYFU). After adjustment for antiretroviral therapy, predictors of death included: female gender (p = 0.02), age at HIV diagnosis (p = 0.005), lowest CD4 count less than 200 cells/mm(3) (p < 0.001) and highest viral load greater than 100,000 copies per milliliter during follow-up (p = 0.007), having an AIDS-defining illness before admission or during follow-up (p < 0.001). We provide evidence that women have benefited less from care, though admitted to the clinic at earlier stages of HIV disease and offered standardised therapeutic interventions. However, the reasons for such gender differences in survival still remain unclear. Further studies are thus warranted to help recognize factors associated to a higher vulnerability in care among women, what may help establish strategies to enhance care for all people living with HIV and for women, in particular.

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“…This shift in the demographics of AIDS has been accompanied by a growing recognition that the clinical manifestation and outcomes of the disease in women and men may be different.3'4 A large prospective study conducted by Terry Beirn Community Programs for Clinical Research on AIDS recently found that HIV-infected women face an increased risk of death when compared with men; during a 15-month period of observation, women had a significantly lower rate of survival even though disease progression rates did not differ significantly by sex. 5 The authors of the study suggest that the reasons for excess mortality in HIVinfected women "might include lower socioeconomic status, homelessness, domestic violence, substance abuse, and the lack of social support." 5(P 1920) At present, there are few empirical data to support or refute their hypothesis.…”

Section: Introductionmentioning

confidence: 99%

The risk of domestic violence and women with HIV infection: implications for partner notification, public policy, and the law.

Rothenberg¹,

Paskey²

1995

Am J Public Health

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Partner notification has emerged as an important strategy in the fight against acquired immunodeficiency syndrome (AIDS), and states have now adopted a plethora of laws that encourage or mandate notification, often without the patient's consent. As human immunodeficiency virus (HIV) infection continues to spread among women, the future development of AIDS control strategies and public health laws must be shaped by concern for the safety and autonomy of patients who face a risk of domestic violence. Three distinct recommendations flow from this premise. First, all HIV-infected women should be assessed for the risk of domestic violence and offered appropriate interventions. Second, where a risk of abuse is indicated, partners should never be notified without the patient's consent. State laws that presently permit involuntary notification should be repealed or amended. Third, laws that punish a patient's refusal to notify partners should also be modified or repealed.

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Survival and Disease Progression According to Gender of Patients With HIV Infection

Cited by 138 publications

References 29 publications

Serum Levels of Virus Burden in Early‐Stage Human Immunodeficiency Virus Type 1 Disease in Women

Serum Levels of Virus Burden in Early‐Stage Human Immunodeficiency Virus Type 1 Disease in Women

Gender Differences in Survival in an HIV/AIDS Cohort from São Paulo, Brazil

The risk of domestic violence and women with HIV infection: implications for partner notification, public policy, and the law.

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