title: [Multicenter cohort of patients with HIV infection in the Madrid south-eastern metropolitan crown (COMESEM): basis, organization and initial results].
abstract: BACKGROUND
  In order to evaluate changes related to the effect of new anti-retroviral agents and preventive programs, cohort studies of patients with HIV in our environment are needed.
  
  
  METHODS
  Cohort study of patients diagnosed of HIV infection in the five hospitals included in the Madrid metropolitan south-eastern crown (COMESEM), which attend a population of 1,300,000 inhabitants.
  
  
  RESULTS
  A total of 5,532 patients had been recruited until August 2001 (with a follow-up of 34,227 patients-year). The male/female ratio was 3/1. As for the transmission mechanism, 72.9% were parenteral drug users (PDU), 13.7% heterosexuals (HTX) and 8% of males having sex with males (MSM). The maximal figure of diagnosis per year corresponded to 1991 for PDU, 1993 for MSM and 1995 for heterosexuals. A decline in the number of diagnosed patients was observed for all groups, but MSM showed an increase in the year 2001 for the first time. Notably, among HTX, a growing and sustained trend was observed of patients not born in Spain (0% in 1993 and 50% in 2001; p < 0.001).
  
  
  CONCLUSIONS
  Establishing a large cohort of HIV infected patients based upon medium-sized hospitals is possible. The analysis of data derived from this cohort allows the early detection of changes in the clinical and epidemiological profile of HIV infection.
authors.affiliation: Area de Medicina. Unidad de Medicina Interna. Fundación Hospital Alcorcón. Alcorcón. Madrid. Spain.
authors.forename: V
authors.initials: V
authors.lastname: Castilla
authors.forename: J C
authors.initials: JC
authors.lastname: Alberdi
authors.forename: C
authors.initials: C
authors.lastname: Barros
authors.forename: J
authors.initials: J
authors.lastname: Gómez
authors.forename: G
authors.initials: G
authors.lastname: Gaspar
authors.forename: J
authors.initials: J
authors.lastname: Sanz
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000635:transmission; D006801:Humans; D008297:Male; D012107:Research Design; D012725:Sexual Behavior; D013030:Spain / Q000453:epidemiology; D015819:Substance Abuse, Intravenous
chemical_list: D019380:Anti-HIV Agents