Although treatment advances have dramatically reduced deaths from opportunistic infections related to AIDS, a new study drawing on 30 years of data from more than 20,000 patients in San Francisco suggests there is still ample room to improve. About a third--35 percent--of AIDS patients diagnosed with their first opportunistic infection from 1997 to 2012 in that city died within five years, according to the study, published in the Journal of Infectious Diseases.
"While recent research suggests that many opportunistic infections in the U.S. are now less common and, oftentimes, less lethal, we cannot forget about them," said Kpandja Djawe, PhD, of the Centers for Disease Control and Prevention (CDC) and the lead author of the study.Untreated HIV infection progresses to AIDS, opportunistic infections, and cancers. These were common during the early years of the U.S. epidemic, when death often quickly followed an AIDS diagnosis: From 1981 to 1986, only 7 percent of patients in San Francisco diagnosed with their first opportunistic infection lived more than five years, according to the study.
Since then, with advances in antiretroviral therapy (ART), wider availability of HIV testing, and improvements in the treatment of opportunistic illnesses, survival rates have markedly risen. During the most recent period analyzed in the study (1997 to 2012), 65 percent of patients diagnosed with an AIDS-related opportunistic infection lived five more years or longer, a trend consistent with other studies.
The remaining 35 percent of AIDS patients--those who died within five years of being diagnosed with an opportunistic infection--underscore the work still to be done to address AIDS-related illnesses today, the authors noted. "Better prevention and treatment strategies, including earlier HIV diagnosis, are needed to lessen the burden of AIDS opportunistic infections, even today, in the combination ART era," said Sandra Schwarcz, MD, senior HIV epidemiologist at the San Francisco Department of Public Health and one of the authors of the study.