Progression to AIDS and death and response to HAART in men and women from a multicenter hospital-based cohort.
OBJECTIVE
To study if progression to AIDS and death, as well as clinical and virological response to highly active antiretroviral therapy (HAART), differs between men and women.


METHODS
We studied a multicenter, hospital-based cohort of HIV-infected patients attending 10 hospitals in Spain from January 1997 to December 2003. Kaplan-Meier and Cox regression were used to assess the effect of sex on time to AIDS, survival from AIDS, onset of a new AIDS event or death, and viral suppression from HAART.


RESULTS
Of 4643 patients, 27% were women. Women had statistically significant lower viral loads (VL) of 3.9 vs. 4.1 log10/mL (p = 0.02) and higher median CD4 counts of 339 vs. 288 cells/mm3 (p < 0.001) at entry and were more likely to be AIDS free at entry. In univariate analysis, women seemed to show a nonsignificant lower progression to AIDS (HR 0.88) (95 CI% 0.73-1.07), which disappeared in multivariate analyses (HR 1.03) (95% CI 0.82-1.29). Survival from AIDS seemed to be higher in women (HR 0.65) (95% CI 0.40-1.05), but differences became clearly nonsignificant after adjustments (HR 0.71) (95% CI 0.42-1.23). No differences were seen in time to new AIDS condition or death after HAART (HR 1.08) (95% CI 0.80-1.46) in multivariate analyses. No differences were seen for time to VL suppression after initiation of HAART (HR 1.07) (95% CI 0.92-1.24).


CONCLUSIONS
We have found no differences in HIV progression and response to HAART attributable to gender among patients accessing the Spanish hospital network.
Perez-Hoyos
Santiago
S
Escuela Valenciana de Estudios en Salud, Community of Valencia, Spain.
Rodríguez-Arenas
M Angeles
MA
García de la Hera
Manuela
M
Iribarren
José A
JA
Moreno
Santiago
S
Viciana
Pompeyo
P
Peña
Alejandro
A
Gómez Sirvent
José L
JL
Saumoy
María
M
Lacruz
José
J
Padilla
Sergio
S
Oteo
José A
JA
Asencio
Román
R
Del Amo
Julia
J
D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000188:drug therapy / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D017678:Sex Distribution; D013030:Spain / Q000453:epidemiology; D016019:Survival Analysis; D019562:Viral Load / Q000706:statistics & numerical data*
D019380:Anti-HIV Agents