Marimoutou C, Chêne G, Dabis F, Lacoste D, Salamon R
Centre d'Information et de Soins de l'Immunodéficience Humaine (CISH, CM, FD, DL), Centre Hospitalier Universitaire (CHU), Bordeaux.
Presse Med. 1997;26(15):703-10.
To describe the hospital-based information system developed by the GESCA (Clinical epidemiology group on AIDS in Aquitaine) and evaluate the main results obtained over the last 10 years, specifically data related to epidemiological monitoring, medico-economic analysis and clinical research in HIV infection.
Inclusion criteria were HIV-1 seropositivity confirmed by Western blot, age over 13 years, consultation or hospitalization is one of the 18 participating units. Follow-up data were collected at each hospital visit.
On December 31, 1995, 4268 subjects had been registered in the GECSA system, including 25.7% women. Contamination categories were homosexuals 33.4%, intravenous drug abusers 32.8%, heterosexuals 13.9%. A clear drop in the number of new cases in intravenous drug abusers and an increase in the number with heterosexual transmission was observed after 1988. The medico-economic analysis showed that patients followed in the system were in a more advanced stage at registry since 1992. More than half of the subjects are now taking antiretroviral therapy and prophylaxis for opportunistic infections. Clinically, after adjusting data for the major known prognosis factors, the risk of progression to AIDS is higher in homosexuals and intravenous drug abusers than in heterosexuals. Transmission route does not however have any significant effect on survival after development of AIDS. There is no significant difference in outcome of HIV infection between men and women and pregnancy is not associated with poorer outcome.
This regional registry provides valuable data for epidemiological monitoring, medico-economic analysis, hospital management and clinical research.
描述由吉斯卡（阿基坦艾滋病临床流行病学组）开发的基于医院的信息系统，并评估过去10年取得的主要成果，特别是与HIV感染的流行病学监测、医学经济分析和临床研究相关的数据。
纳入标准为经免疫印迹法确认HIV-1血清学阳性、年龄超过13岁、在18个参与单位之一进行咨询或住院治疗。每次医院就诊时收集随访数据。
1995年12月31日，4268名受试者已在GECSA系统中登记，其中女性占25.7%。感染类别为同性恋者33.4%、静脉吸毒者32.8%、异性恋者13.9%。1988年后观察到静脉吸毒者新病例数量明显下降，异性传播病例数量增加。医学经济分析表明，自1992年以来，在该系统中接受随访的患者在登记时处于更晚期阶段。现在超过一半的受试者正在接受抗逆转录病毒治疗和机会性感染预防。临床上，在对主要已知预后因素的数据进行调整后，同性恋者和静脉吸毒者进展为艾滋病的风险高于异性恋者。然而，传播途径对艾滋病发病后的生存没有任何显著影响。男女之间HIV感染的结果没有显著差异，怀孕与较差的结果无关。
这个区域登记系统为流行病学监测、医学经济分析、医院管理和临床研究提供了有价值的数据。
