Carpenter CC, Leibman BD, Stein M, Fisher A, Fiore TC, Mayer KH; International Conference on AIDS.
Int Conf AIDS. 1991 Jun 16-21; 7: 298 (abstract no. M.C.3000).
Brown University AIDS Program (BRUNAP), Providence, RI, USA
OBJECTIVE: To define the epidemiology, clinical characteristics, and distinctive features of HIV seropositive women in Rhode Island (RI). METHODS: 200 HIV seropositive women (mean age 33+/-4 years: 54% Caucasian, 28% Black, 16% Hispanic) consecutively referred to BRUNAP physicians during 1986-1990 were evaluated at 3-6 month intervals for periods of 12 to 60 months. Epidemiologic patterns, clinical characteristics, and immunologic evaluations were systematically recorded. All received antiretroviral therapy and prophylaxis and/or treatment for opportunistic infections when appropriate. RESULTS: A major change in dominant mode of transmission occurred during this study. Before 1989, 21% of transmission occurred via the heterosexual (HTX) route, with the remainder associated with intravenous drug use (IVDU). During 1990, 67% of newly diagnosed individuals were infected via the HTX route. Over the entire time period, Hispanic women were more likely than Caucasian or Black women to become infected by the HTX route (P less than .001 by t test). High grade squamous intraepithelial lesions (SIL) were very frequent (41%) on Papanicolaou smears of women infected via IVDU. High-grade SILs were much less frequent (4%) in women infected via the HTX route (P less than .001 by t test). Mean initial CD4 lymphocyte counts (cells/mm(3)) at time of diagnosis were not different in the 2 transmission groups (504+/-410 (SD) in HTX group; 546+/-430 (SD) in IVDU group). This cohort of women demonstrated a mean annual decrease in CD4 lymphocyte counts of 56 +/- 24 (SD) and a mean decrease in Karnofsky score of 4+/-5 per annum. The most common AIDS-defining events were esophageal candidiasis (33%), chronic mucocutaneous herpes simplex infections (25%), and Pneumocystis carinii pneumonia (22%). No significant differences in rates of disease progression were observed between HTX and IVDU transmission groups. CONCLUSIONS: The HTX route is now the dominant mode of HIV transmission in women in RI. Women who have acquired HIV infection via IVDU have a significantly greater prevalence of high grade cervical SIL than women with HTX acquired infection. Clinical progression of HIV infection in women is similar to that reported in larger groups of American men in the same age group. Relative frequencies of specific AIDs-defining events in RI women differ from those observed in larger cohorts of North American men.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- CD4 Lymphocyte Count
- CD4-Positive T-Lymphocytes
- Candidiasis
- Disease Progression
- Female
- HIV Infections
- HIV Seropositivity
- Humans
- Male
- Neoplasms, Squamous Cell
- Pneumonia, Pneumocystis
- Prevalence
- Rhode Island
- Substance Abuse, Intravenous
- Vaginal Smears
- transmission
Other ID:
UI: 102183386
From Meeting Abstracts