TY - JOUR
T1 - Effectiveness of highly active antiretroviral therapy in Spanish cohorts of HIV seroconverters
T2 - Differences by transmission category
AU - Pérez-Hoyos, Santiago
AU - Del Amo, Julia
AU - Muga, Roberto
AU - Del Romero, Jorge
AU - García De Olalla, Patricia
AU - Guerrero, Rafael
AU - Hernàndez-Aguado, Ildefonso
AU - Ferreros, Inmaculada
AU - Cayla, Joan
AU - Brugal, Teresa
AU - Garcia De La Hera, Manoli
AU - Hurtado, Isabel
AU - Gonzàlez-Aracil, Julian
AU - Aviñó, M. José
AU - Muga, Robert
AU - Sanvicens, Arantza
AU - Clotet, Bonaventura
AU - Tor, Jordi
AU - Rodríguez, Carmen
AU - Díez, Mercedes
AU - García, Soledad
AU - Soriano, Vicente
AU - Marco, Andrés
AU - Quintana, Manolo
AU - Barrasa, Alicia
AU - Ruiz, Isabel
AU - Tussell, Joan
AU - Perez, Rosario
AU - Cisneros, José Miguel
AU - Castilla, Jesús
PY - 2003/2/14
Y1 - 2003/2/14
N2 - Objective: To evaluate the population effectiveness of highly active antiretroviral therapy (HAART) in HIV progression and determine the heterogeneity of the effect of HAART in GEMES (Spanish multicenter study of seroconverters). Design: Multicenter cohort study. Methods: Data from 1091 persons with well-documented HIV seroconversion dates from 1980s to January 2000 were analysed. Risk of AIDS and death in subjects with same duration of HIV infection were compared in different calendar periods; before 1992, 1992-1995 (reference), 1996-1997, 1998 and 1999 with Kaplan-Meier methods and Cox proportional hazards models, allowing for late entry, fitting calendar period as time-dependent covariate and adjusting for transmission category, age and gender. Results: Statistically significant reductions in the risk of AIDS were first observed in 1998 [hazard ratio (HR), 0.59; 95% confidence interval (CI), 0.35-1.01] becoming more pronounced in 1999 (HR, 0.45; 95% Cl, 0.24-0.84). Reduction in the risk of death was seen in 1997, though only reached borderline significance in 1999 (HR, 0.53; 95% Cl, 0.26-1.07). Progression to AIDS and death was slower in women (HR, 0.68; 95% Cl, 0.46-0.99 and HR, 0.53; 95% Cl, 0.33-0.87, respectively). Compared with men who have sex with men (MSM), intravenous drug users (IDU) had lower reductions in the risk of AIDS and death. Conclusions: Reductions in incidence of AIDS and death in GEMES are seen after 1998 and 1999, respectively, compared with 1992-1995, being more pronounced in MSM compared with IDU, the commonest category in Spain.
AB - Objective: To evaluate the population effectiveness of highly active antiretroviral therapy (HAART) in HIV progression and determine the heterogeneity of the effect of HAART in GEMES (Spanish multicenter study of seroconverters). Design: Multicenter cohort study. Methods: Data from 1091 persons with well-documented HIV seroconversion dates from 1980s to January 2000 were analysed. Risk of AIDS and death in subjects with same duration of HIV infection were compared in different calendar periods; before 1992, 1992-1995 (reference), 1996-1997, 1998 and 1999 with Kaplan-Meier methods and Cox proportional hazards models, allowing for late entry, fitting calendar period as time-dependent covariate and adjusting for transmission category, age and gender. Results: Statistically significant reductions in the risk of AIDS were first observed in 1998 [hazard ratio (HR), 0.59; 95% confidence interval (CI), 0.35-1.01] becoming more pronounced in 1999 (HR, 0.45; 95% Cl, 0.24-0.84). Reduction in the risk of death was seen in 1997, though only reached borderline significance in 1999 (HR, 0.53; 95% Cl, 0.26-1.07). Progression to AIDS and death was slower in women (HR, 0.68; 95% Cl, 0.46-0.99 and HR, 0.53; 95% Cl, 0.33-0.87, respectively). Compared with men who have sex with men (MSM), intravenous drug users (IDU) had lower reductions in the risk of AIDS and death. Conclusions: Reductions in incidence of AIDS and death in GEMES are seen after 1998 and 1999, respectively, compared with 1992-1995, being more pronounced in MSM compared with IDU, the commonest category in Spain.
KW - Gender
KW - HAART
KW - HIV progression
KW - Highly active antiretroviral therapy
KW - Population effectiveness
KW - Seroconverters
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U2 - 10.1097/00002030-200302140-00009
DO - 10.1097/00002030-200302140-00009
M3 - Article
C2 - 12556689
AN - SCOPUS:0037436185
SN - 0269-9370
VL - 17
SP - 353
EP - 359
JO - AIDS
JF - AIDS
IS - 3
ER -