A low-cost, sustainable, second generation system for surveillance of people living with HIV in Spain: 10-year trends in behavioural and clinical indicators, 2002 to 2011

Díez, Mercedes; Díaz, Asunción; Garriga, César; Reus-Pons, Matias; Ten, Ana Sales; Marcos, Henar; Gutiérrez, Félix; Moreno, Santiago; González-García, Juan; Barrios, Ángela; Arponen, Sari; García, Marcial; Royo, María Carmen García; Toledo, J.; González, Gustavo; Aranguren, Rosa; Izquierdo, Ana; Viloria, Luis Javier; Elizalde, L.; Martínez, Eva; Castrillejo, Daniel; López, Irene; Redondo, C. López; Cano, Ariel

doi:10.2807/1560-7917.es2014.19.20.20805

Cited by 12 publications

(9 citation statements)

References 15 publications

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“…Several factors could have influenced these findings. First, the proportion of known HIV-infected individuals receiving cART in Spain has increased significantly over the last decade, and more patients have a fully suppressed HIV viral load, a less advanced CDC clinical stage, and higher CD4+ T-cell counts [21]. These factors are important, because the results of a randomized clinical trial show that continuous suppression of HIV with cART reduces not only the risk of new AIDS-defining conditions and death, but also the risk of non–AIDS-defining conditions including cardiovascular events [24].…”

Section: Discussionmentioning

confidence: 99%

“…This possibility seems to be justified by the observation that although mortality trends for HIV-infected individuals in Spain declined significantly when the first years of the cART era are taken as the reference, this was mostly at the expense of HIV-monoinfected patients, since declines in mortality rates were not observed among HIV/HCV-coinfected patients [30]. It is important to mention that injection drug use has been—and remains so today—the predominant mode of HIV acquisition in patients with HCV antibodies in Spain [10, 21, 29]. In other words, these patients are not only at risk of AIDS-related and liver-related deaths, but they are also at risk of death related to lifestyle factors including substance use, accidents, and suicide [10].…”

Section: Discussionmentioning

confidence: 99%

“…The number of HIV-monoinfected and HIV/HCV-coinfected individuals in Spain was estimated using the results of the hospital survey of HIV/AIDS-infected patients, a second-generation surveillance system in people living with HIV coordinated by the National Centre of Epidemiology [21]. We also used reports from two Spanish national cohorts: the “Grupo de Estudio de Sida” (GeSIDA) [10] and the “Asociación Médica VACH de Estudios Multicentricos (AMVACH)” [22] (Table B in S1 File).…”

Section: Methodsmentioning

confidence: 99%

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Stroke in HIV-infected individuals with and without HCV coinfection in Spain in the combination antiretroviral therapy era

et al. 2017

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The incidence of stroke in human immunodeficiency virus (HIV)–infected individuals has been well analyzed in recent epidemiological studies. However, little is known about the specific contribution of hepatitis C virus (HCV) infection to stroke among HIV-infected individuals. The aims of this study were to analyze trends in the incidence rates of stroke in HIV-infected individuals during the combination antiretroviral (cART) era in Spain and to categorize them by the presence or absence of HCV coinfection. We analyzed hospital discharges with a diagnosis of stroke in Spain according to ICD-9-CM during 1997–2013. The study period was divided into four calendar periods (1997–1999, 2000–2003, 2004–2007, and 2008–2013). Patients were classified according to HCV serology. The number of HIV-infected patients was estimated based on data from the National Centre of Epidemiology. We calculated incidence rates (events per 10,000 patient-years) and in-hospital case fatality rates (CFR). The incidence of hemorrhagic stroke (HS) decreased in HIV-monoinfected patients (15.8 [1997–1999] to 6.5 [2008–2013]; P<0.001) and increased in HIV/HCV-coinfected patients (1.3 [1997–1999] to 5.5 [2008–2013]; P<0.001). The incidence of ischemic stroke (IS) decreased in HIV-monoinfected patients (27.4 [1997–1999] to 21.7 [2008–2013]; P = 0.005) and increased in HIV/HCV-coinfected patients (1.8 [1997–1999] to 11.9 [2008–2013]; P<0.001). The CFR was 3.3 times higher for HS than for IS for the whole study period. The CFR of HS in HIV-monoinfected patients decreased significantly (47.4% [1997–1999] to 30.6% [2008–2013]; P = 0.010) but did not change significantly among HIV/HCV-coinfected patients (41.4% [1997–1999] to 44.7% [2008–2013]; P = 0.784). The CFR of IS in the whole HIV-infected population decreased significantly (14.6% [1997–1999] to 10.9% [2008–2013]; P = 0.034), although no significant differences were found when each group was analyzed separately. In conclusion, after the introduction of cART, HS and IS rates decreased in HIV-monoinfected individuals, but increased steadily in HIV/HCV-coinfected individuals.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Stroke in HIV-infected individuals with and without HCV coinfection in Spain in the combination antiretroviral therapy era

et al. 2017

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“…We expected to find worse survival in low-medium household income districts which our Unit had previously observed using other neighbourhood deprivation indicators [ 29 ]. Indeed, a national survey in Spain showed that employment among HIV patients was low (45.8%) [ 58 ]. Additionally, some of responders in this survey were living in prison (3.0%), other closed facilities (5.0%) or were homeless (1.8%).…”

Section: Discussionmentioning

confidence: 99%

Mortality, Causes of Death and Associated Factors Relate to a Large HIV Population-Based Cohort

et al. 2015

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IntroductionAntiretroviral therapy has led to a decrease in HIV-related mortality and to the emergence of non-AIDS defining diseases as competing causes of death. This study estimates the HIV mortality rate and their risk factors with regard to different causes in a large city from January 2001 to June 2013.Materials and MethodsWe followed-up 3137 newly diagnosed HIV non-AIDS cases. Causes of death were classified as HIV-related, non-HIV-related and external. We examined the effect of risk factors on survival using mortality rates, Kaplan-Meier plots and Cox models. Finally, we estimated survival for each main cause of death groups through Fine and Gray models.Mortality Results182 deaths were found [14.0/1000 person-years of follow-up (py); 95% confidence interval (CI):12.0–16.1/1000 py], 81.3% of them had a known cause of death. Mortality rate by HIV-related causes and non-HIV-related causes was the same (4.9/1000 py; CI:3.7–6.1/1000 py), external was lower [1.7/1000 py; (1.0–2.4/1000 py)].Survival ResultsKaplan-Meier estimate showed worse survival in intravenous drug user (IDU) and heterosexuals than in men having sex with men (MSM). Factors associated with HIV-related causes of death include: IDU male (subHazard Ratio (sHR):3.2; CI:1.5–7.0) and <200 CD4 at diagnosis (sHR:2.7; CI:1.3–5.7) versus ≥500 CD4. Factors associated with non-HIV-related causes of death include: ageing (sHR:1.5; CI:1.4–1.7) and heterosexual female (sHR:2.8; CI:1.1–7.3) versus MSM. Factors associated with external causes of death were IDU male (sHR:28.7; CI:6.7–123.2) and heterosexual male (sHR:11.8; CI:2.5–56.4) versus MSM.Conclusion and RecommendationThere are important differences in survival among transmission groups. Improved treatment is especially necessary in IDUs and heterosexual males.

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“…For this purpose, we reviewed the results from the hospital survey of HIV/AIDS infected patients, a second-generation surveillance system in people living with HIV coordinated by the National Centre of Epidemiology [30], and the reports of two Spanish national cohorts: the “Grupo de Estudio de Sida” (GeSIDA) [31] and the “Asociación Médica VACH de Estudios Multicentricos (AMVACH)” [32]. From these sources we obtained the percentage of patients with HCV antibodies.…”

Section: Methodsmentioning

confidence: 99%

Trends in Epidemiology of COPD in HIV-Infected Patients in Spain (1997–2012)

et al. 2016

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PurposeThe aim of this study was to estimate trends of incidence of hospital admissions and in-hospital mortality (IHM) in HIV-infected patients with COPD in the combination antiretroviral therapy (cART) era in Spain (1997–2012).MethodsA retrospective study with data from nationwide population-based COPD diagnoses in the Spanish Minimum Basic Data Set (MBDS) was performed. We established groups according to their HIV and HCV infections: 1) HIV-uninfected patients; 2) HIV-infected patients (with or without HCV coinfection).Results1,580,207 patients discharge with a COPD diagnosis were included in the study, 8902 of them were HIV-infected patients (5000 HIV-monoinfected patients and 3902 HIV/HCV-coinfected patients). The HIV-infected patients had higher incidence rates of hospital admissions for COPD than the HIV-uninfected patients during the study period. The HIV-monoinfected patients had higher rates of hospitalizations for COPD than the HIV/HCV-coinfected patients in the early-period cART (1997–1999), but these rates decreased in the first group and increased in the second, being even similar in both groups in the late-period cART (2004–2011). On the other hand, the HIV-infected patients with COPD had higher IHM than the HIV-uninfected patients with COPD. The mortality rates were higher in the HIV-monoinfected patients with COPD than in the HIV/HCV-coinfected patients with COPD in the early-period cART; however, in the late-period cART, the mortality rates trends seems higher in the HIV/HCV group. The likelihood of death in HIV/HCV-coinfected patients with COPD was similar to than in HIV-monoinfected patients with COPD.ConclusionsIncidence of hospital admissions for COPD and IHM have decreased among HIV-monoinfected individuals but have increased steadily among HIV/HCV-coinfected individuals in the cART era.

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A low-cost, sustainable, second generation system for surveillance of people living with HIV in Spain: 10-year trends in behavioural and clinical indicators, 2002 to 2011

Cited by 12 publications

References 15 publications

Stroke in HIV-infected individuals with and without HCV coinfection in Spain in the combination antiretroviral therapy era

Stroke in HIV-infected individuals with and without HCV coinfection in Spain in the combination antiretroviral therapy era

Mortality, Causes of Death and Associated Factors Relate to a Large HIV Population-Based Cohort

Trends in Epidemiology of COPD in HIV-Infected Patients in Spain (1997–2012)

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