American Journal of Epidemiology Vol. 138, No. 5: 341-349
Copyright © 1993 by The Johns Hopkins University School of Hygiene and Public Health
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Survival and Mortality Patterns of an Acquired Immunodeficiency Syndrome (AIDS) Cohort in New York State
From the Bureau of Communicable Disease Control, New York State Department of Health Albany, NY
Reprint requests to Hwa-Gan Chang, New York State Department of Health, Corning Tower Building, Room 632, Empire State Plaza, Albany, NY 12237
The survival experience and causes of death of acquired immunodeficiency syndrome (AIDS) patients were studied using a cohort of 3,699 AIDS patients in New York State, excluding New York City, whose illness was diagnosed before January 1990 at age 13 years or older. The median length of survival for all cases was 11.5 months, and survival increased over time from 5.3 months pre-1984 to 9.3 months in 19841986 and to 13.2 months in 19871989. In a Cox proportional hazards model, risk of dying was higher for persons aged 35 years or more at diagnosis and for persons with a diagnosis other than Pneumocystis carinii pneumonia or Kaposi's sarcoma whose illness was diagnosed before 1986. In this AIDS cohort, 2,834 (77 percent) persons died before 1991; 87 percent of the death certificates listed human immunodeficiency virus (HIV)/AIDS or an AIDS indicator disease as one of the multiple causes of death. The finding that 13 percent of the death certificates did not mention AIDS/HIV suggests that use of death certificates alone to count HIV-related deaths would result in an undercount. The recent expansion of the federal AIDS case definition is expected to add HIV-infected persons who die from conditions, such as recurrent pneumonia, that were not included in the earlier definition. Am J Epidemiol 1993;138:3419.
acquired immunodeficiency syndrome; mortality; proportional hazards models; risk; survival
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