AIDS Across Europe, 1994-98: The EuroSIDA Study [Mocroft A, et al. Lancet 2000; 356: 291]: This is a report from the EuroSIDA Study Group, which is a prospective, observational, multicenter study with about 7,300 patients in 52 European HIV clinics. During the study period of 1994 to 1998 there were 1,667 AIDS-defining conditions. These declined from 30.7 per hundred patient years in 1994 to 2.5 per hundred patients years in 1998 (p = < 0.0001). These changes were accompanied by an increase in the median CD4 cell count at the time of an AIDS defining diagnosis from 28 cells/mm³ in 1994 to 125 cells/mm³ in 1998. The most striking declines in OIs were for MAC bacteremia and CMV retinitis, and a significant increase in the relative proportion of cases of non-Hodgkin lymphoma, which showed a four-fold increase.
Comment: These observations are consistent with those reported by other groups except possibly with regard to total magnitude. The authors ascribed the dramatic decline in AIDS-defining diagnoses to HAART according to guidelines, but they further comment that "our data suggest that the CD4 lymphocyte count value used for cut-offs in guidelines, if anything, could be lowered for patients receiving HAART." posted 8/7/2000