Epidemiological trends of HIV infection in Spain

Suárez-Lozano, Ignacio; Fajardo, José María; Garrido, Myriam; Roca, Bernardino; García-Alcalde, M Luisa; Geijo, Paloma; Selma, Daniel; Lozano, Fernando; Teira, Ramón; Viciana, Pompeyo; Pérez-Cortés, Salvador; Domingo, Peré; Menchero, Antonia; Galindo, Marı́a José; Cosín, Jaime; Ribera, Esteban; Arribas, José Ramón; Lacalle-Remigio, Juan R.

doi:10.1097/00002030-200212060-00023

Cited by 28 publications

(6 citation statements)

References 5 publications

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“…Characteristics of this cohort have been described elsewhere [7]. In summary, the VACH cohort collects clinical information of HIV-infected patients form 47 centres throughout the Spanish geography.…”

Section: Methodsmentioning

confidence: 99%

Dyslipidaemia in HIV-infected women on antiretroviral therapy. Analysis of 922 patients from the Spanish VACH cohort

et al. 2011

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BackgroundInformation concerning lipid disturbances in HIV-infected women on antiretroviral therapy (ART) is scarce. The objective of the study is to describe the lipid profile in a large cohort of HIV-infected women on contemporary ART and analyse differences between regimes and patient's characteristics.MethodsObservational, multicentre, cross-sectional study from the Spanish VACH Cohort. 922 women on stable ART without lipid-lowering treatment were included.ResultsMedian age was 42 years, median CD4 lymphocyte count was 544 cells/mm3, and 85.6% presented undetectable HIV-1 viral load. Median total cholesterol (TC) was 189 mg/dL (interquartile range, IQR, 165-221), HDL cholesterol 53 mg/dL (IQR, 44-64), LDL cholesterol 108 mg/dL (IQR, 86-134), and triglycerides 116 mg/dL (IQR, 85-163). Mean accumulated time on ART was 116 months; 47.4% were on NNRTI-based regimes, 44.7% on PI, and 6.7% on only-NRTI therapy. 43.8% were also hepatitis C (HCV) coinfected. Patients on PI treatment presented higher TC/HDL ratio than those on NNRTI (p < 0.001). Significantly higher HDL values were observed in NNRTI-treated patients. HCV-coinfected patients presented lower TC/HDL ratio than the non HCV-coinfected. In multivariate analysis, factors independently associated with TC/HDL ratio were age, triglyceride levels and HCV co-infection. PI treatment presented a non-significant association with higher TC/HDL ratio.ConclusionsIn HIV-infected women, the NNRTI-based ART is associated with a better lipid profile than the PI-based. Factors unrelated to ART selection may also exert an independent, significant influence on lipids; in particular, age, and triglyceride levels are associated with an increased TC/HDL ratio while HCV co-infection is associated with a reduced TC/HDL ratio.

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Section: Methodsmentioning

confidence: 99%

Dyslipidaemia in HIV-infected women on antiretroviral therapy. Analysis of 922 patients from the Spanish VACH cohort

et al. 2011

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“…An extensive description of the inclusion criteria, methodology, and patients' characteristics has been published previously [14,15]. Patients were asked to sign an informed consent form prior to inclusion in the cohort.…”

Section: Methodsmentioning

confidence: 99%

The relationship between antiretroviral prescription patterns and treatment guidelines in treatment‐naïve HIV‐1‐infected patients

et al. 2009

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Reports have shown that the publication of practice guidelines does not guarantee their use in clinical practice. The objective of this study was to evaluate the agreement between antiretroviral treatments (ARTs) prescribed in clinical practice and the recommendations in published guidelines. ResultsA total of 945 patients initiated ART. Of these patients, 12.3% had a CD4 cell count above 350 cells/mL. A 'nonrecommended' antiretroviral regimen was prescribed to 5.3, 5.1 and 7.8% of patients with CD4 counts o200, 200-350 and 4350 cells/mL, respectively. Multivariate analyses demonstrated that only a higher viral load was associated with the selection of a combination treatment that was recommended by the guidelines. ConclusionsMost patients were prescribed initial treatments in agreement with the recommendations. Appropriate routine data collection in databases can be used to evaluate the level of antiretroviral guideline compliance. We propose that routine evaluations of the guidelines must be part of quality assessment to improve medical care. IntroductionThe use of clinical practice guidelines (CPG) to orientate medical decision making is becoming increasingly common for many diseases [1]. In Spain, both the National Plan against AIDS and the AIDS Study Group of the Spanish The influence that antiretroviral treatment (ART) recommendations have on antiretroviral combination therapy in clinical practice has been poorly studied. Although there are studies on temporal trends in antiretroviral drug use, few studies have analysed the relationship between prescriptions and CPG. The little information available on the subject consists of data from different sources, including audits performed in individual hospitals [6][7][8], periodical reports from the British HIV Association [9], and a few cohort studies [10][11][12]. In the present study we evaluate the degree of agreement between initial ART prescriptions and Spanish CPG recommendations. Additionally, we ascertain the feasibility of using clinical databases as a source of information for treatment audits. MethodsThe Asociacion Medica Vach de Estudios Multicentricos (VACH) Cohort recruits patients from 19 hospitals belonging to the Spanish National Health Service, which are located in 15 different cities and nine autonomous communities. The VACH sites cover approximately 15% of the total Spanish population. Nearly 14 000 patients, aged 16 years or older, were included in the cohort at the time of the study. Their personal and clinical data were recorded in a common computer database (ACyH s , Betek 43 SL, Huelva, Spain). Laboratory tests, including measurements of the CD4 cell count and viral load, were performed every 4-6 months and results recorded in the database. AIDS cases were identified using the current European criteria [13].An extensive description of the inclusion criteria, methodology, and patients' characteristics has been published previously [14,15]. Patients were asked to sign an informed consent form prior to inclusion in the cohort. Personal da...

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“…For example, in many HIV surveillance efforts (e.g., Dubois-Arber et al, 2010; Likatavicius, Klavs, Devaux, Alix, & Nardone, 2008; Sánchez et al, 2007; Suárez-Lozano et al, 2002; Tabet at al., 2002), MTF transgender women (assigned a male sex at birth who identify as female) are often included as a subgroup of men who have sex with men (MSM). However, gender identity is not synonymous with sexual orientation.…”

Section: Introductionmentioning

confidence: 99%

Using a Two-Step Method to Measure Transgender Identity in Latin America/the Caribbean, Portugal, and Spain

et al. 2014

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Few comparative data are available internationally to examine health differences by transgender identity. A barrier to monitoring the health and well-being of transgender people is the lack of inclusion of measures to assess natal sex/gender identity status in surveys. Data were from a cross-sectional anonymous online survey of members (n > 36,000) of a sexual networking website targeting men who have sex with men in Spanish- and Portuguese-speaking countries/ territories in Latin America/the Caribbean, Portugal, and Spain. Natal sex/gender identity status was assessed using a two-step method (Step 1: assigned birth sex, Step 2: current gender identity). Male-to-female (MTF) and female-to-male (FTM) participants were compared to non-transgender males in age-adjusted regression models on socioeconomic status (SES) (education, income, sex work), masculine gender conformity, psychological health and well-being (lifetime suicidality, past-week depressive distress, positive self-worth, general self-rated health, gender related stressors), and sexual health (HIV-infection, past-year STIs, past-3 month unprotected anal or vaginal sex). The two-step method identified 190 transgender participants (0.54%; 158 MTF, 32 FTM). Of the 12 health-related variables, six showed significant differences between the three groups: SES, masculine gender conformity, lifetime suicidality, depressive distress, positive self-worth, and past-year genital herpes. A two-step approach is recommended for health surveillance efforts to assess natal sex/gender identity status. Cognitive testing to formally validate assigned birth sex and current gender identity survey items in Spanish and Portuguese is encouraged.

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Epidemiological trends of HIV infection in Spain

Cited by 28 publications

References 5 publications

Dyslipidaemia in HIV-infected women on antiretroviral therapy. Analysis of 922 patients from the Spanish VACH cohort

Dyslipidaemia in HIV-infected women on antiretroviral therapy. Analysis of 922 patients from the Spanish VACH cohort

The relationship between antiretroviral prescription patterns and treatment guidelines in treatment‐naïve HIV‐1‐infected patients

Using a Two-Step Method to Measure Transgender Identity in Latin America/the Caribbean, Portugal, and Spain

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