The Edinburgh City Hospital cohort: analysis of enrolment, progression and mortality by baseline covariates

We describe baseline characteristics, enrolment, progression and mortality of the Edinburgh City Hospital HIV cohort. There were 431 men and 191 (31%) women; 439 (71%) infected via injection drug use (IDU); 92 (15%) via homosexual intercourse; 84 (13%) via heterosexual intercourse and 7 from blood products. Median annual rate of CD4 cell loss was 49 (90% range: 15–146); Both homosexual men and patients aged >40 years at enrolment lost CD4 cells significantly more quickly. In multifactorial analysis controlled for baseline CD4 count and IgA, there was no gender effect, but young patients (< 25 years) progressed significantly more slowly to AIDS (RR 0.4, p = 0.00). Homosexual men progressed significantly more quickly than IDUs, with adjusted relative risks (RR) of 2.9 (p=0.00), 2.5 (p=0.01) and 1.5 (p = 0.1) for progression to CDC stage IV, AIDS and death, respectively. The three-year survival rate post-AIDS was 25% (SE 4.3) and there was no gender effect on survival. There was, however, an age effect whereby individuals diagnosed with AIDS in their 40s or later showed poorer survival (RR 1.9, p = 0.04). Zidovudine treatment after an AIDS diagnosis significantly lengthened post-AIDS survival (RR 0.5, p = 0.08).