The "AIDS Presenters" phenomenon, thirteen years after the availability of potent, combination antiretroviral therapy

Abstract

Results Compared with the pre-cART era, a significant drop of frequency of overall AIDS cases occurred: from a mean 58.3 ± 11.2 patients-year observed in the decade 19861995, to 13.7 ± 6.0 patients-year during years 2001-2008 (p < .001), together with an increased mean age (p < .002), female gender (p < .01), sexual vs i.v. transmission (p < .001), and proportion of immigrant versus native p (p < .02). In the cART era, the most evident drop of frequency interested opportunistic diseases linked to a CD4 + lymphocyte count below 50-100 cells/μL, while a proportional rise of tuberculosis, pneumonia, lymphomas, and other neoplasms was observed. The frequency of both Candida esophagitis and Pneumocystis carinii pneumonia remained stable, as the first two most frequent AIDS-related conditions. After cART availability, the following diagnoses in crude frequency were represented by neurotoxoplasmosis, wasting syndrome, AIDS-dementia complex, and non-Hodgkin’s lymphomas. P with multiple AIDS-defining diseases, and also AIDS diagnoses made only at or after death, even showed a paradoxically increased frequency and absolute number during the cART era versus the prior decade (p < .001 and p < .03), while no difference was found as to the grade of HIVassociated immunodeficiency. Surprisingly, an underlying anti-HIV therapy was a more common event until 1995, versus p observed in the cART era (p < .001), since during recent years AIDS notification tends to be increasingly associated with the first diagnosis of HIV infection.