Trends in survival of HIV infected patients attending the Department of Genito-Urinary Medicine, Royal Infirmary of Edinburgh.

In the early 1980s, median survival for patients with the acquired immunodeficiency syndrome (AIDS) was only 11 months. Survival improved in the mid-1980s, reaching a median of 20 months. We have looked at the trends in survival of patients attending the Genito-urinary Medicine Department of Edinburgh Royal Infirmary between 1984 and 1996. Patients with an AIDS diagnosis between 1988 and 1991 had a median survival of 28 months, whereas patients given an AIDS diagnosis between 1992 and 1996 had a median survival of only 15 months (p = 0.01). However, survival from the point at which the CD4 lymphocyte count fell below 200 (CD4 200) remained unchanged. Patients diagnosed as AIDS after 1992 were more likely to have received prophylaxis against Pneumocystis carinii pneumonia or anti-retroviral therapy prior to an AIDS diagnosis. This may have resulted in the postponement of an AIDS defining diagnosis until the patients were more severely immuno-compromised, but has conferred no overall survival benefit.