Egea J M, Muga R, Sirera G, Clotet B, Tor J, Ardèvol M, Rey-Joly C, Muñoz A
Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain.
Epidemiol Infect. 2002 Oct;129(2):325-33. doi: 10.1017/s0950268802007495.
The prevalence of anti-retroviral therapy (ART) use over time and the incidence of AIDS in a cohort of HIV-seroconverting injecting drug users (IDUs) were assessed by means of a hospital-based study of IDUs with a well documented date of HIV infection. Use of ART and clinical endpoints were assessed by hospital records. Three calendar periods (before 1992, 1992-6 and 1997-2000) were defined as corresponding to modalities of ART available. Prevalence of ART usage in each calendar period, changes in medication and, hazard of AIDS in patients reaching the same duration of HIV infection at different calendar periods were analysed. In total, 132 IDUs with a median age of 23 years at seroconversion were followed up for 6.8 years (median) (range 0.2-15.7). At the end of the study, 58 patients (44%) had developed AIDS. Before the introduction of highly active anti-retroviral therapy (HAART) 12% of patients were on ART. Starting in 1997, an increasing proportion were receiving HAART with a prevalence of 39.5% by January 2000. Taking 1992-6 as the reference category the relative hazard of AIDS during 1997-2000 was 0.42 (95% CI, 0.1-1.1) (P = 0.09). A 40% penetration of HAART in a cohort of IDUs with known dates of seroconversion resulted in a 58 % reduction of the hazard of AIDS.
通过一项基于医院的对有详细记录的HIV感染日期的注射吸毒者（IDU）队列研究，评估了抗逆转录病毒疗法（ART）随时间的使用情况以及艾滋病的发病率。通过医院记录评估ART的使用情况和临床终点。定义了三个日历时间段（1992年之前、1992 - 1996年和1997 - 2000年），分别对应可用的ART治疗方式。分析了每个日历时间段内ART的使用 prevalence、药物变化以及在不同日历时间段达到相同HIV感染时长的患者中患艾滋病的风险。总共对132名血清转化时中位年龄为23岁的IDU进行了6.8年（中位）的随访（范围0.2 - 15.7年）。研究结束时，58名患者（44%）发展为艾滋病。在高效抗逆转录病毒疗法（HAART）引入之前，12%的患者接受ART治疗。从1997年开始，接受HAART的比例不断增加，到2000年1月患病率达到39.5%。以1992 - 1996年作为参考类别，1997 - 2000年期间患艾滋病的相对风险为0.42（95%可信区间，0.1 - 1.1）（P = 0.09）。在已知血清转化日期的IDU队列中，HAART的渗透率达到40%，导致患艾滋病的风险降低了58%。
