title: [Changes in clinic-epidemiological characteristics of new cases of HIV-1 infection in Castellón (Spain), and its impact on delayed presentation (1987-2011)].
abstract: OBJECTIVE
  To describe the trend of the clinical and epidemiological characteristics of a cohort of HIV-1 infected patients in Castellón (Spain), and its impact on the delayed presentation.
  
  
  METHODS
  Data from HIV-1 infected outpatients presenting for care for the first time between 1987 and 2011 were retrospectively analyzed.
  
  
  RESULTS
  There have been significant changes in the characteristics of the 1001 newly presented patients during the period studied. An increase in the mean age was observed (increasing from about 30 years before 1996, to approximately 35 after the 2000-2002 period), as well as an increase in the percentage of immigrants (<2% before 1997, to 50% in the 2009-2011 period), and a decline in the proportion of intravenous drug use as the main transmission route (changing from being 92.3% before 1988 to below 20% after the 2003-2005 period), together with a decrease in the proportion of hepatitis-C coinfection. The rate of late presentation has not significantly changed, being 47.1% in the period studied. Factors associated with this late presentation were: older age, hospital diagnosis, an increased delay between estimated infection time and diagnosis, and between diagnosis and initial presentation.
  
  
  CONCLUSIONS
  The epidemiology of HIV-1 infection in our area has dramatically changed since the beginning of the disease. The increasing delay between estimated infection time and diagnosis is an important cause of the lack of variation in the late presentation rate, and highlights the low impact of early diagnosis strategies.
authors.affiliation: Servicio de Medicina Interna/Unidad de Enfermedades Infecciosas, Hospital Universitario General de Castellón, Castelló de la Plana, Castellón, España. Electronic address: cminguez@comcas.es.
authors.forename: Carlos
authors.initials: C
authors.lastname: Mínguez-Gallego
authors.affiliation: Servicios Médicos, Centro Penitenciario Castellón I, Castelló de la Plana, Castellón, España.
authors.forename: Enrique J
authors.initials: EJ
authors.lastname: Vera-Remartinez
authors.affiliation: Servicio de Medicina Interna, Hospital Universitario General de Castellón, Castelló de la Plana, Castellón, España.
authors.forename: Monica
authors.initials: M
authors.lastname: Albert-Coll
authors.affiliation: Servicio de Medicina Interna, Hospital Universitario General de Castellón, Castelló de la Plana, Castellón, España.
authors.forename: M Concepción
authors.initials: MC
authors.lastname: Roldán-Puchalt
authors.affiliation: Servicio de Medicina Interna, Hospital Universitario General de Castellón, Castelló de la Plana, Castellón, España.
authors.forename: Manuel
authors.initials: M
authors.lastname: Aguilar-Climent
authors.affiliation: Servicio de Medicina Interna, Hospital Universitario General de Castellón, Castelló de la Plana, Castellón, España.
authors.forename: Rosa E
authors.initials: RE
authors.lastname: Rovira-Ferrando
authors.affiliation: Servicio de Medicina Interna/Unidad de Enfermedades Infecciosas, Hospital Universitario General de Castellón, Castelló de la Plana, Castellón, España.
authors.forename: Jorge
authors.initials: J
authors.lastname: Andrés-Soler
authors.affiliation: Servicio de Medicina Interna, Hospital Universitario General de Castellón, Castelló de la Plana, Castellón, España.
authors.forename: Belén
authors.initials: B
authors.lastname: Roig-Espert
authors.affiliation: Servicio de Medicina Interna, Hospital Universitario General de Castellón, Castelló de la Plana, Castellón, España.
authors.forename: María
authors.initials: M
authors.lastname: Penadés-Vidal
authors.affiliation: Servicio de Medicina Interna/Unidad de Enfermedades Infecciosas, Hospital Universitario General de Castellón, Castelló de la Plana, Castellón, España.
authors.forename: Jorge
authors.initials: J
authors.lastname: Usó-Blasco
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D057210:Delayed Diagnosis / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology*; D015497:HIV-1; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology; D013997:Time Factors
keywords: Diagnóstico tardío; Epidemiology; Epidemiología; Human immunodeficiency virus infection; Infección por el virus de la inmunodeficiencia humana; Late presentation; Late testing; Retraso diagnóstico