Physicians' Experience and Survival in Patients with AIDS

Abstract
In the report by Kitahata et al. (March 14 issue),1 we were somewhat surprised by the conclusion that the experience of physicians is associated with the length of survival after the development of AIDS in patients seropositive for the human immunodeficiency virus (HIV). We recently showed that patients who had previously received medical care lived a significantly shorter time after the development of AIDS than patients who had an AIDS-defining illness when they first presented, probably because effective intervention delayed the onset of AIDS until immunosuppression was more advanced (as shown by the presence of diseases associated with severe immunosuppression).2