[Clinical-epidemiological characteristics and antiretroviral treatment trends in a cohort of HIV infected patients. The PISCIS Project].
OBJECTIVE
The aims of this study were to describe the process of implementation of the PISCIS cohort, and to describe the clinical and epidemiological characteristics and trends of antiretroviral treatment (ART) among patients enrolled from 1998 through 2003.


METHODS
Prospective cohort study of HIV-infected patients aged > or = 16 years newly attended in 10 Catalonian hospitals and one Balearic Islands hospital. Analysis were done using the Mantel's chi2 test for trend.


RESULTS
A total of 5,968 patients (mean age 39 yrs; 75% men) were recruited with a mean follow-up of 26.4 months (13,130 person-years). A total of 2,763 patients were newly diagnosed and among these, the most frequent transmission route was the heterosexual one (43%), followed by homosexual (31%). We observed an increasing trend in the proportion of persons < 35 years and immigrants. Among newly diagnosed, 43% had < 200 CD4 T cells/microl in the nearest determination from HIV diagnosis. In the year 2003, 83% of patients were on ART. A decrease of the protease inhibitor-based regimen (from 85% in 1998 to 25% in 2003; p < 0.001) and an increase of nucleoside and non-nucleoside analogue reverse transcriptase inhibitors-containing regimens were observed over time among naive patients who started ART with three or more drugs.


CONCLUSIONS
HIV infected patients' cohorts are feasible in our setting and are an important tool in clinical and public health. The heterosexual route of transmission was the most frequent among newly diagnosed patients. The diagnosis delay is high and, on the other hand, ARV regimens have been changing according to the recommended guidelines.
Jaén
Angeles
A
Centre d'Estudis Epidemiològics sobre la SIDA de Catalunya (CEESCAT), DGSP, Departament de Salut, Badalona, Barcelona, Spain.
Casabona
Jordi
J
Esteve
Anna
A
Miró
Jose M
JM
Tural
Cristina
C
Ferrer
Elena
E
Riera
Melchor
M
Segura
Ferran
F
Force
Lluís
L
Sued
Omar
O
Vilaró
Josep
J
Masabeu
Angels
A
García
Isabel
I
Dorca
Esther
E
Altès
Jordi
J
Navarro
Gemma
G
Podzamczer
Daniel
D
Villalonga
Concepción
C
Clotet
Bonaventura
B
Gatell
Josep M
JM
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000639:trends*; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology