[HIV/AIDS--from lethal syndrome to chronic disease]

Abstract

Background: At its discovery in 1981, AIDS was a fatal syndrome that rapidly led to death. Combination treatment with at least three drugs has radically improved the prognosis.

Material and methods: The study includes all HIV-patients controlled at the Department of Infectious Diseases, Ullevål University Hospital from 1982 to 2005. Development of immune deficiency, morbidity and causes of death were registered prospectively. Possible connections between death and HIV-infection and treatment were evaluated.

Results: 1632 patients were followed at our department. 32 % of these patients have died. The number of patients who died annually during the 5 years from 1986 to 1990 was 47 % and this was reduced to 11 % in 2001 - 05. Many patients still die because they either present too late for treatment or have received insufficient treatment. 22 patients have died during the last 10 years irrespective of starting treatment with at least 3 antiretroviral drugs: 7 died from cancers, 6 from treatment failure, one from unknown cause and 8 from other causes. The 6 patients who died from treatment failure had very low CD4 counts and serious opportunistic infections that could not be treated effectively at the time of diagnosis.

Interpretation: Patients who start and adhere to treatment with 3 HIV-medications have a good prognosis, but they may still have an increased risk of non-AIDS defining cancers and cardiovascular disease. HIV/AIDS has become a chronic disease with a good prognosis.