Gómez M A, Velázquez M, Hunter R F
Internal Medicine Department, Universidad Central del Caribe, Bayamon, P.R. 00960-6032.
Bol Asoc Med P R. 1997 Jul-Sep;89(7-9):111-6.
To present the general socio-demographic profile, some risk related parameters and elements of the clinical spectrum of disease at presentation, of those HIV/AIDS patients enrolled in the Human Retrovirus Registry.
This is a prospective longitudinal cohort study, which has been identifying since May 1992, adults or adolescents 18 years or older with AIDS or HIV infection at the time they present to our health care facilities: University Hospital Ramon Ruiz Arnau and the Bayamon Immunology Clinic. The present analysis include patients enrolled between May 1992 and December 1996 (n = 1520). The measurement instrument is a modular questionnaire which actually includes 237 variables including socio-demographic data, risk variables, lifestyle and affective parameters, clinical and immunological variables and therapeutic data.
The mean baseline age of the 1520 patients was 35.7 years of age. Most participants were male (77.7%) and Hispanic (98.8%). Forty-five percent (45.1%) of the population were single and only 21.9% were married; nevertheless, fifty-one percent (51.7%) indicated to have children. 70% reported to be unemployed. Injecting Drug Usage appears as the first exposure mode (54.3%), followed by heterosexual contact cases (25.71%) and by men having sex with men (12.9%). The study of other risk practices revealed a large proportion of patients smoking tobacco (65.6%) and using alcohol (49.5%). Based on the 1993 CDC definition, forty-seven percent (47%) of the subjects had a clinical or immunological criterion to be considered as an AIDS case at first presentation. Among all AIDS cases, 440 patients presented with clinical AIDS (61.7%%) and 274 persons were classified as AIDS due to low CD4 counts alone (38.3%%). The most common AIDS defining conditions were: Pneumocystis carinii pneumonia (n = 201, 28.1%), Candidiasis Esophageal (n = 123, 17.2%), Toxoplasmosis (n = 95, 13.3%), Wasting syndrome (n = 68, 9.5%), and Tuberculosis (n = 68, 10.3%).
The socio-demographic and risk profile of AIDS patients in the present study is representative of the Puerto Rican AIDS population with regards to gender, age distribution, and risk scenario groups. This study revealed that a wide spectrum of social and behavioral vulnerabilities are impacting this population. A large proportion of patients is arriving to the health care facilities at a late stage of disease. Further studies including data from follow-up interviews will help to assess changes in the expression and evolution of the disease.
介绍纳入人类逆转录病毒登记处的艾滋病病毒/艾滋病患者的一般社会人口学特征、一些与风险相关的参数以及就诊时疾病临床谱的要素。
这是一项前瞻性纵向队列研究，自1992年5月起，对在我们的医疗机构（拉蒙·鲁伊斯·阿尔瑙大学医院和巴亚蒙免疫诊所）就诊时年龄在18岁及以上的艾滋病或艾滋病毒感染的成年人或青少年进行识别。本分析纳入了1992年5月至1996年12月期间登记的患者（n = 1520）。测量工具是一份模块化问卷，实际上包括237个变量，包括社会人口学数据、风险变量、生活方式和情感参数、临床和免疫变量以及治疗数据。
1520名患者的平均基线年龄为35.7岁。大多数参与者为男性（77.7%）且为西班牙裔（98.8%）。45.1%的人口为单身，只有21.9%已婚；然而，51.7%的人表示有孩子。70%的人报告失业。注射吸毒是首要暴露方式（54.3%），其次是异性接触病例（25.71%）和男男性行为者（12.9%）。对其他风险行为的研究显示，很大一部分患者吸烟（65.6%）和饮酒（49.5%）。根据1993年美国疾病控制与预防中心的定义，47%的受试者在首次就诊时有临床或免疫标准被视为艾滋病病例。在所有艾滋病病例中，440名患者表现为临床艾滋病（61.7%），274人仅因CD4细胞计数低被归类为艾滋病（38.3%）。最常见的艾滋病定义疾病为：卡氏肺孢子虫肺炎（n = 201，28.1%）、食管念珠菌病（n = 123，17.2%）、弓形虫病（n = 95，13.3%）、消瘦综合征（n = 68，9.5%）和结核病（n = 68，10.3%）。
本研究中艾滋病患者的社会人口学和风险特征在性别、年龄分布和风险情况组方面代表了波多黎各艾滋病人群。该研究表明，广泛的社会和行为脆弱性正在影响这一人群。很大一部分患者在疾病晚期才到医疗机构就诊。包括随访访谈数据在内的进一步研究将有助于评估疾病表现和演变的变化。
