000			nab a22 7a 4500
999			_c17663 _d17663
003			PC17663
005			20230804113337.0
008			230804b xxu||||| |||| 00| 0 eng d
040			_cH12O
041			_aeng
100			_91500 _aRubio García, Rafael _eUnidad de VIH
245	0	0	_aClinical outcomes of patients infected with HIV through use of injected drugs compared to patients infected through sexual transmission: late presentation, delayed anti-retroviral treatment and higher mortality. _h[artículo]
260			_bAddiction (Abingdon, England), _c2016
300			_a111(7):1235-45.
500			_aFormato Vancouver. Suárez García I, Sobrino Vegas P, Dalmau D, Rubio R, Iribarren JA, Blanco JR et al; Cohort of the Spanish HIV Research Network (CoRIS). Clinical outcomes of patients infected with HIV through use of injected drugs compared to patients infected through sexual transmission: late presentation, delayed anti-retroviral treatment and higher mortality. Addiction. 2016 Jul;111(7):1235-45.
501			_aPMID: 26890155
504			_aContiene 59 referencias
520			_aAims: To compare patients who acquired HIV infection through use of injected drugs (HIV-IDU) with patients who acquired HIV by sexual transmission (HIV-ST) in terms of late presentation (LP), delay in anti-retroviral treatment (ART) initiation, virological and immunological response to ART, mortality and progression to AIDS. Design: Prospective multi-centre cohort study of HIV-infected subjects naive to ART at entry (Cohort of the Spanish HIV Research Network: CoRIS). Setting: Thirty-one centres from the Spanish public health-care system. Participants: A total of 9355 patients were included (1064 HIV-IDU and 8291 HIV-ST) during 2004-13. Measurements: We compared LP (defined as presentation for care with a CD4 cell count < 350/μl and/or AIDS-defining illness), delayed ART initiation (defined as initiating treatment more than 6 months after the date when treatment was indicated by the guidelines, or not initiating treatment at all when it was indicated), virological and immunological response to ART (defined as viral load < 50 HIV-1 RNA copies/ml and a CD4 count increase of at least 100 cells/μl, respectively, after 1 year of treatment), mortality and progression to AIDS in HIV-IDU and HIV-ST. Findings: Compared with HIV-ST, HIV-IDU had higher risk of LP [odds ratio (OR) = 1.76; 95% confidence interval (CI) = 1.41-2.18], delayed ART initiation (OR 1.87; 95% CI = 1.46-2.40) and higher mortality [hazard ratio (HR) = 1.43; 95% CI = 1.03-2.01] and risk of progression to AIDS [subhazard ratio (SHR) = 1.68; 95% CI = 1.29-2.18]. Virological suppression due to ART was lower in HIV-IDU than in patients with HIV-ST only among patients without hepatitis C virus (HCV) infection [adjusted OR (aOR) = 0.59; 95% CI = 0.36-0.95]; among patients with HCV infection, virological suppression due to ART did not show significant differences between HIV-IDU and HIV-ST. There were no significant differences in immunological response after adjusting by HCV (aOR = 0.74; 95% CI = 0.52-1.06). Conclusions: In Spain, patients who acquire HIV infection through use of injected drugs appear to have a higher risk of late presentation, delayed initiation of anti-retroviral treatment and progression to AIDS and death than patients who acquire HIV by sexual transmission.
710			_96 _aServicio de Medicina Interna
856			_uhttp://pc-h12o-es.m-hdoct.a17.csinet.es/pdf/pc/1/pc17663.pdf _ySolicitar documento
942			_2ddc _cART _n0