X-Message-Number: 4636
From:  (David Stodolsky)
Subject: Staging System for Clinical AIDS Patients
Date: Mon, 17 Jul 95 14:00:02 +0200 (CET DST)


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"Staging System for Clinical AIDS Patients"
Lancet (07/01/95) Vol. 346, No. 8966, P. 12;  Mocroft, Amanda J.;
Johnson, Margaret A.;  Sabin, Caroline A. et al.
     Mocroft et al. propose dividing AIDS patients into a single
staging system that accounts for prognostic factors such as type
and number of AIDS-related diseases and CD4 lymphocyte count.  A
finer distinction would be useful in circumstances including
designing entry and endpoint criteria in clinical trials, they
note.  The researchers followed more than 350 AIDS patients in
England and reported the occurrence of 680 AIDS-defining diseases
(ADDs).  The severity of the ADDs was defined on the basis of
survival in the AIDS in Europe study of close to 6,600 AIDS
patients--mild included Kaposi's sarcoma, Pneumocystis carinii
pneumonia, and extrapulmonary tuberculosis; severe included all
other ADDs except lymphoma, which was rated very severe.  The
risk of death increased 15 percent for each mild condition
experienced, by nearly 90 percent for each new severe condition,
and by 535 percent when a lymphoma appeared.  Using the Cox
model, the researchers concluded that patients in AIDS Grade I
had a mean death rate of one per 10.1 years, compared with one in
2.8 years in AIDS Grade II and one in 1.1 years in AIDS Grade
III.  The authors feel their staging system would be useful for
patient management, clinical trial design, surveillance, and
resource management.


David S. Stodolsky      Euromath Center     University of Copenhagen
   Tel.: +45 38 33 03 30   Fax: +45 38 33 88 80 (C)


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