The impact of highly active antiretroviral combination therapy in HIV infected patients in Glasgow.
OBJECTIVE
To assess the impact of treatment with highly active antiretroviral therapy on morbidity and mortality in the HIV infected population in Glasgow.


METHODS
Retrospective analysis of the HIV clinical and pharmacy databases in a Department of Infectious Diseases, the major provider of HIV treatment and care in Glasgow.


METHODS
The study population comprised all HIV infected individuals who attended the Department of Infectious Diseases as inpatients or outpatients from April 1994 to March 1999. The main outcome measures were the number of deaths; the number of new AIDS diagnoses; expenditure on drugs for the treatment or prevention of opportunistic infections; hospital admissions of HIV patients; and occupied bed days.


RESULTS
The number of patients attending in each year was 215 in 1994-95, rising to 242 in 1998-99. During the same time period there was a 75% reduction in the number of deaths (36 in 1994-95 falling to 10 in 1998-99) and the number of AIDS diagnoses (28 to 7), and a 50% reduction in occupied bed days (3,278 to 1,676) and hospital admissions of HIV infected patients (328 to 164). This occurred at a time when antiviral drug therapy for HIV infection shifted from monotherapy to dual therapy and subsequently to triple or quadruple therapy. In the last two years of the study the majority of treated patients were on a three or four drug regimen.


CONCLUSIONS
Between 1994 and 1999 there was a marked reduction in the morbidity and mortality of the HIV infected population in Glasgow. This was most likely due to the introduction and widespread use of highly active antiretroviral drug therapy.
Fox
R
R
Department of Infectious Diseases, Brownlee Centre, Gartnavel General Hospital, Glasgow.
Gourlay
Y J
YJ
D023241:Antiretroviral Therapy, Highly Active / Q000191:economics / Q000706:statistics & numerical data*; D016527:Drug Costs; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D007902:Length of Stay; D008297:Male; D010343:Patient Admission / Q000639:trends; D012189:Retrospective Studies; D012606:Scotland / Q000453:epidemiology; D016019:Survival Analysis; D016896:Treatment Outcome; D014504:Urban Health