Survival and medical intervention in southern Brazilian AIDS patients

The aim of the study was to describe survival patterns of Southern Brazilian AIDS patients: 224 predominantly working class AIDS patients were treated in an AIDS referral centre in Porto Alegre between October 1986 and September 1991. The caseload increased progressively, as did the number of female AIDS cases treated at the Hospital during the study period. Self-referred patients were more likely to present with an AIDS defining condition (P < 0.03) and they (n = 106) had significantly worse survival patterns compared with patients referred by other health care professionals (n = 112; P < 0.04). Median survival from the time of AIDS diagnosis was 5 months which did not change significantly during the study period (P = 0.38). Patients (n = 42) presenting with opportunistic infections other than mycobacterial disease (n = 42), Pneumocystis carinii pneumonia (n = 37) or candidiasis (n = 18), had significantly worse survival patterns (P = 0.001). Patients treated with zidovudine (n = 33) survived significantly longer from time of AIDS diagnosis than those not on zidovudine (n = 185; P = 0.0002). No significant survival differences were observed from time of AIDS diagnosis between those who commenced on zidovudine before developing AIDS (n = 17) and those who were treated with zidovudine since diagnosed with AIDS (n = 16; P = 0.80). During the study period zidovudine was only available through private prescriptions. Survival of Southern Brazilian AIDS patients has not improved: earlier access to HIV-related services and the provision of effective and affordable therapeutic interventions are two measures which could improve future survival patterns.