Over 1/3 HIV Patients Who Develop Opportunistic Infection Die Within Five Years

MedicalResearch.com Interview with:
Sandra Schwarcz, MD
Senior HIV epidemiologist
San Francisco Department of Public Health

Medical Research: What is the background for this study? What are the main findings?

Dr. Schwarcz: AIDS opportunistic illnesses continue to occur despite effective antiretroviral therapy. Although previous studies examined survival following a diagnosis of an opportunistic illness, there are few recent reports that are population-based. The San Francisco Department of Public Health has the only population-level data on the occurrence of and survival following opportunistic illnesses and use of antiretroviral therapy among persons reported with HIV in the United States. By measuring survival following the occurrence of opportunistic illnesses, we were able to document that survival following opportunistic illnesses has improved with better HIV treatment. However, opportunistic illnesses continue to occur and carry substantial mortality risk. Even in this era of effective HIV therapy, we found that 35% of persons who developed an opportunistic illness died within five years of their diagnosis and some opportunistic illnesses such as brain lymphoma and  progressive multifocal leukoencephalopathy remain highly lethal.

Medical Research: What should clinicians and patients take away from your report?

Dr. Schwarcz: Patients who are diagnosed earlier in the course of HIV disease and who receive prompt HIV care and treatment, including antiretroviral therapy have the best chance of avoiding opportunistic illnesses. Clinicians should provide HIV testing routinely for patients who may be at risk of infection and provide prompt treatment for their disease along with counseling regarding the importance of medication adherence. Clinicians should monitor their patients for response to therapy and the occurrence of HIV-related and HIV-non-related morbidities.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Schwarcz: Additional research regarding prevention and treatment of AIDS-related opportunistic illnesses is needed to improve survival.

Journal References:

  1. Sandra Schwarcz et al. Mortality Risk After AIDS-De fi ning Opportunistic Illness Among HIV-Infected Persons — San Francisco, 1981 – 2012. Journal of Infectious Diseases., June 2015 DOI: 10.1093/infdis/jiv235
  2. Henry Masur, and Sarah W. Read. Opportunistic Infections and Mortality: Still Room for Improvement. Journal of Infectious Diseases, June 2015 DOI: 10.1093/infdis/jiv236

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Sandra Schwarcz, MD,, Senior HIV epidemiologist, & San Francisco Department of Public Health (2016). Over 1/3 HIV Patients Who Develop Opportunistic Infection Die Within Five Years