Survival and disease progression according to gender of patients with HIV infection

HIV-infected women may have a greater risk of death than HIV-infected men, although the overall risk of disease progression may not differ significantly according to gender. Researchers studied the medical, demographic, and HIV risk factor data of 768 HIV-infected women and 3,779 HIV-infected men to determine gender-based differences in disease progression and death. After a median follow-up period of 14.5 to 15.5 months, the women were 1.33 times more likely to die than the men, independent of the patients' CD4 counts and other variables associated with the disease. The risk of disease progression measured in terms of AIDS-related infections was similar among patients of both genders. Women were more likely to develop bacterial pneumonia or other mycobacterial infections as men. But they were less likely to develop nonvisceral Kaposi's sarcoma or oral hairy leukoplakia .
Objective.--To compare disease progression and mortality between women and men infected with human immunodeficiency virus (HIV). Design.--Multicenter cohort. Setting.--Seventeen community-based centers participating in the Terry Beirn Community Programs for Clinical Research on AIDS (CPCRA). Patients.--A total of 768 women and 3779 men enrolled in one or more of 11 protocols between September 7, 1990, and September 30, 1993. Main Outcome Measures.--Survival and opportunistic events. Results.--The median CD[4.sup.+] cell count at enrollment into the cohort was 0.240 x[10.sup.9]/L (240/[micro]L) for women and 0.137 x [10.sup.9]/L for men (P Conclusions.--Compared with men, HIV-injected women in the CPCRA were at increased risk of death but not disease progression. Risks of most incident opportunistic diseases were similar for women and men; however, women were at an increased risk of bacterial pneumonia. These findings may reflect differential access to health care and standard treatments or different socioeconomic status and social support for women compared with men. (JAMA. 1994;272:1915-1921)