Document Type

Article

Peer Reviewed

1

Publication Date

6-24-2015

NLM Title Abbreviation

PLoS One

Journal/Book/Conference Title

PLoS One

PubMed ID

26107253

DOI of Published Version

10.1371/journal.pone.0123119

Total Pages

11

Abstract

OBJECTIVES: Neurologic complications of human immunodeficiency virus (HIV) infection and acquired immune deficiency syndrome (AIDS) frequently lead to disability or death in affected patients. The aim of this study was to determine whether survival patterns differ between men and women with HIV/AIDS-related neurologic disease (neuro-AIDS).

METHODS: Retrospective cohort data from a statewide surveillance database for HIV/AIDS were used to characterize survival following an HIV/AIDS-related neurologic diagnosis for men and women with one or more of the following conditions: cryptococcosis, toxoplasmosis, primary central nervous system lymphoma, progressive multifocal leukoencephalopathy, and HIV-associated dementia. A second, non-independent cohort was formed using university-based cases to confirm and extend the findings from the statewide data. Kaplan-Meier analysis was used to compare the survival experiences for men and women in the cohorts. Cox regression was employed to characterize survival while controlling for potential confounders in the study population.

RESULTS: Women (n=27) had significantly poorer outcomes than men (n=198) in the statewide cohort (adjusted hazard ratio=2.31, 95% CI: 1.22 to 4.35), and a similar, non-significant trend was observed among university-based cases (n=17 women, 154 men). Secondary analyses suggested that this difference persisted over the course of the AIDS epidemic and was not attributable to differential antiretroviral therapy responses among men and women.

CONCLUSIONS: The survival disadvantage of women compared to men should be confirmed and the mechanisms underlying this disparity elucidated. If this relationship is confirmed, targeted clinical and public health efforts might be directed towards screening, treatment, and support for women affected by neuro-AIDS.

Keywords

OAfund, HIV, AIDS, neurologic disease

Granting or Sponsoring Agency

NIH

Grant Number

T32 GM07337 and TL1 RR024981

Comments

Training support for Martha Carvour was provided through NIH grants T32 GM07337 and TL1 RR024981. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Journal Article Version

Version of Record

Published Article/Book Citation

PLoS ONE 10(6): e0123119. doi:10.1371/journal.pone.0123119

Rights

This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose.

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons 1.0 Public Domain Dedication.

Included in

Epidemiology Commons

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URL

https://ir.uiowa.edu/epi_pubs/2