Journal Information
Vol. 13. Issue 5.
Pages 337-345 (September - October 1999)
Vol. 13. Issue 5.
Pages 337-345 (September - October 1999)
Open Access
Tiempo libre de SIDA y supervivencia de una cohorte de usuarios de drogas por vía parenteral seroconvertores frente al VIH
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S. Pérez-Hoyos1,
Corresponding author
sperez@san.gva.es

S. Pérez-Hoyos. Institut Valencià d'Estudis en Salut Pública. C/ Joan de Garay 21.46017 València
, M.J. Aviñó1, I. Hernández2, J. González1, I. Ruiz1, por el Grupo Valenciano de Estudios de la Epidemiología e infección del VIH
1 Institut Valencià d'Estudis en Salut Pública (IVESP)
2 Departamento de Salud Pública. Universidad Miguel Hernández
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Abstract
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Resumen
Objetivo

Analizar el período de incubación al SIDA, la supervivencia y la supervivencia pre-SIDA para una cohorte de usuarios de drogas por vía parenteral (UDVP), seroconversores al VIH.

Sujetos y métodos

Se disponía el intervalo en el que se produjo la seroconversión para 276 UDVPs provenientes de los Centros de Información y Prevención del SIDA (CIPS) reclutados desde mediados de 1987 hasta junio de 1996. Se obtuvo la fecha de diagnóstico de SIDA y estatus vital a partir del seguimiento en Hospitales, registros de Mortalidad y Sida y visitas a los CIPS, cerrando el seguimiento en diciembre del 96. Se estimo el instante de la seroconversión como el punto medio entre la última visita VIH– y la primera VIH+. Se utilizó la extensión de Kaplan-Meier y la regresión de Cox para datos truncados para estimar el período de incubación y supervivencia y para observar diferencias por sexo, edad, tiempo de consumo y año de seroconversión. Se ajustaron modelos paramétricos Weibull y log-normal para estimar la mediana y percentiles de la distribución de los tiempos a SIDA y muerte.

Resultados

34 casos han sido identificados como SIDA, 24 como muertes siendo nueve de ellas antes del SIDA. A los siete años el 63,5% de los individuos estaban libres de SIDA, y la probabilidad de fallecer era 25,5‰. La mortalidad pre-SIDA se sitúa en torno al 8,7%. No se observan diferencias significativas para el sexo, edad, tiempo de consumo y año de seroconversión. El modelo log-normal mostró un mejor ajuste obteniendo una mediana de tiempo libre de Sida de 10,93 años y de 13,67 años hasta la muerte.

Conclusión

El período de incubación de la infección por VIH en una cohorte de seroconversores en nuestro entorno se sitúa alrededor de 11 años, que no difiere de manera importante de las observadas en otros lugares fuera del área mediterránea como Holanda, Edimburgo o Estados Unidos.

Palabras clave:
Período de incubación
VIH
usuarios de drogas por vía parenteral
Log-normal
supervivencia
Summary
Objective

To analyze AIDS free time, survival and the pre-AIDS survival for a injecting drug users cohort (IDU) of HIV seroconvertors.

Subject and Methods

Interval for seroconversion was available for 276 IDUs from Centers for AIDS Information and Prevention (CIPS) recruited between 1987 and juny of 1996. AIDS diagnosis and vital status dates were obtained by follow up at hospitals, mortality and AIDS registries, and CIPS visits. The end of follow up was December of 1996. Seroconversion date was estimated as the middle point between last HIV– and first HIV+. Kaplan-Meier extension and Cox regression for truncated data were fitted to estimate AIDS-free and survival times and to observe differences by sex, age consumption time and year of seroconversion. Weibull, and Log-normal parametric models were fitted to estimate median and percentiles of AIDSfree and survival times distribution.

Results

34 cases have been identified as AIDS, 24 as deaths, 9 of them being before AIDS. 63.5% of the individuals were AIDS-free 7 years after seroconversion, and the probability of death was 25.5‰. Pre-AIDS mortality is around 8.7%. There were not significant differences by sex, age, consumption time and year of seroconversion. Log-normal model fitted better estimating an AIDS-free median time of 10.93 years and 13.67 survival years

Conclusion

The incubation period of HIV infection in a cohort of seroconvertors in our environment was around 11 years, not different from that observed out of the Mediterranean area as Holland, Scotland or United States

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