title: Regional and temporal changes in AIDS in Europe before HAART.
abstract: In a prospective observational study 4,485 patients from 46 clinical centres in 17 European countries were followed between April 1994 and November 1996. Information on AIDS-defining events (ADEs) were collected together with basic demographic data, treatment history and laboratory results. The centres were divided into four geographical regions (north, central, south-west and south-east) so that it was possible to identify any existing regional differences in ADEs. The regional differences that we observed included a higher risk of all forms of Mycobacterium tuberculosis infections (Tb) and wasting disease in the south-west and an increased risk of infections with the Mycobacterium avium complex (MAC) in the north. In Cox multivariable analyses, where north was used as the reference group, we observed hazard ratios of 6.87, 7.77, 2.29 and 0.16 (P < 0.05 in all cases) for pulmonary Tb, extrapulmonary Tb, wasting disease and MAC respectively in the south-west. Pneumocystis carinii pneumonia (PCP) was less commonly diagnosed in the central region (RH = 0.51, 95% CI 0 32-0.79, P = 0.003) and most common in the south-east (RH = 1.04, 95% CI 0.71-1.51, P = 0.85). Comparisons with a similar 'AIDS in Europe' study that concentrated on the early phase of the epidemic reveal that most of the regional differences that were observed in the 1980s still persist in the mid-1990s.
authors.affiliation: Department of Infectious Disease, Karolinska Hospital, Stockholm, Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Blaxhult
authors.forename: Z
authors.initials: Z
authors.lastname: Fox
authors.forename: R
authors.initials: R
authors.lastname: Colebunders
authors.forename: P
authors.initials: P
authors.lastname: Francioli
authors.forename: Z
authors.initials: Z
authors.lastname: Ben-Ishai
authors.forename: G
authors.initials: G
authors.lastname: Fätkenheuer
authors.forename: J M
authors.initials: JM
authors.lastname: Parkin
authors.forename: P
authors.initials: P
authors.lastname: Vanhems
authors.forename: A N
authors.initials: AN
authors.lastname: Phillips
authors.forename: O
authors.initials: O
authors.lastname: Kirk
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology*; D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy* / Q000453:epidemiology*; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D016021:Epidemiologic Studies; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male