7‐11 November 2010, Tenth International Congress on Drug Therapy in HIV Infection, Glasgow, UK

7‐11 November 2010, Tenth International Congress on Drug Therapy in HIV Infection, Glasgow, UK

Objectives To define the characteristics of 1899 patients diagnosed with AIDS at Lyon University Hospitals (LUH) across four time periods corresponding to different antiretroviral eras, and to analyse the evolution of specific AIDS‐defining illnesses (ADIs) with time. Methods All AIDS patients at LUH between 1 January 1985 and 31 December 2000 were included in the study. The data were compared using the χ2 test and one‐way analysis of variance. Results The absolute number of new AIDS cases increased by 30.3% between 1985 and 1995 but decreased by 26.5% between 1996 and 2000. The proportion of women with AIDS increased significantly (P<0.001) and mean age at diagnosis also increased significantly over time (P<0.001). The proportion of infection through heterosexual contact increased dramatically, while that through homo/bisexual intercourse or injection drug use (IDU) decreased significantly (P<0.001). The absolute number of ADIs declined with the introduction of highly active antiretroviral therapies (HAART) (P<10–6). Pneumocystis carinii pneumonia remained the leading ADI in 1996–2000 (23.3%). A significant increase in the proportion of non‐Hodgkin's lymphoma (NHL) was observed over time (P<10–5) but the number of new NHL cases decreased during HIV infection after 1996. Conclusions The decline in the incidence of AIDS with the advent of HAART was confirmed in our hospital cohort. The gradual increase in the proportion of NHL among ADIs underscores the long latency period between infection with HIV and the achievement of an effect of HAART on HIV‐associated lymphomagenesis.

SummaryA diagnosis of AIDS shortly after the detection of HIV antibodies suggests a long-lasting course of the disease without care. The factors associated with a short delay between the initial HIV-1-positive test and the first AIDS-defining event were identified in 1901 patients from 1985 to 2001 in Lyon University hospitals. A total of 576 individuals (30.3%) had an interval of 3 months between the detection of HIV infection and AIDS. The factors independently associated with a delay of 3 months were: age from 30 to 44 years [odds ratio (OR) 2.5; 95% confidence interval (CI) 1.9-3.2]; age from 45 to 59 years (OR 5.6; 95% CI 3.9-7.8); age ! 60 years (OR 4.5; 95% CI 2.5-8.1), compared to thoseo30 years old; heterosexuality (OR 2.4; 95% CI 1.6-3.4); injection drug use (OR 2.1; 95% CI 1.5-2.7); and other exposures (OR 2.4; 95% CI 1.6-3.4), compared to homosexual exposure; two opportunistic infections at AIDS (OR 1.8; 95% CI 1.4-2.4) compared to one; and Pneumocystis carinii pneumonia as initial AIDS event (OR 2.6; 95% CI 1.8-3.7), compared to Kaposi's sarcoma. These results provide opportunities to refocus local public health interventions to reduce delayed access to care.

ObjectivesWe compared the characteristics of these patients with the characteristics of those diagnosed previously with AIDS. MethodsData for all patients with AIDS diagnosed at Lyon University Hospitals were analyzed. The data were collected prospectively. Multiple logistic regression was used for analysis. Results The variables independently associated with an AIDS diagnosis in