Epidemiology and outcome of HIV infection in North-East Scotland (1985-1997).
OBJECTIVE
to assess the epidemiology of HIV infection in North-East Scotland.


METHODS
retrospective casenote review of all HIV-infected patients who have had contact with the Infection Unit in Aberdeen.


RESULTS
one hundred and forty-two HIV-infected patients were treated between April 1985 and December 1997. The risk behaviour related to the acquisition of the HIV infection was: 56 (39%) homosexually infected, 45 (32%) heterosexually-infected, 34 (24%) injecting drug users (IDUs), and seven (5%) blood products or not known. Sixteen of the 45 (36%) heterosexually-infected patients were native to Africa and 16 of the 34 (31%) IDUs were prisoners in Peterhead prison at the time of referral. Fifty-two (37%) of the cohort continue to attend the Infection Unit, 41 (29%) have relocated, 40 (28%) have died and nine (6%) have been lost to follow-up. The ratio of heterosexual:homosexual men:IDUs changed significantly between the first 7 years (12:21:25) and the second 6 years (33:35:9) of the review, with significantly more patients being infected through heterosexual contact and fewer infected by IDU in the second period-P<0.001. The median AIDS survival was 17 months. Survival was significantly longer in those patients who took anti-retroviral therapy (median = 20 months) than in the patients who opted not to take anti-retroviral therapy (median = 11 months)-P<0.01.


CONCLUSIONS
Although homosexual contact represents the commonest risk group for HIV infection in this region, the number of heterosexually-infected patients has increased significantly in the last 5 years. Temporary residents account for one-third of the HIV-infected population cared for in NE Scotland. Almost half of those lost to follow-up have returned to Africa or been released from prison. The introduction of anti-retroviral therapy has resulted in a dramatic improvement in AIDS survival in our cohort as it has done elsewhere.
Mackenzie
A R
AR
The Infection Unit, Aberdeen Royal Infirmary, Scotland, UK.
Laing
R B
RB
Urbaniak
S J
SJ
Molyneaux
P J
PJ
Douglas
J G
JG
Smith
C C
CC
D000349:Africa; D019380:Anti-HIV Agents / Q000627:therapeutic use; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D006467:Hemophilia A / Q000150:complications; D020010:Heterosexuality; D006716:Homosexuality; D006801:Humans; D008297:Male; D011329:Prisoners; D012189:Retrospective Studies; D012307:Risk Factors; D012606:Scotland / Q000453:epidemiology; D015819:Substance Abuse, Intravenous / Q000150:complications; D015996:Survival Rate; D016896:Treatment Outcome
D019380:Anti-HIV Agents