Acquired immunodeficiency syndrome in the province of Cadiz. A study of 269 consecutive patients

The epidemiological characteristics clinical manifestations and survival were analyzed in 269 patients with acquired immunodeficiency syndrome (AIDS) diagnosed in the province of Cadiz through June of 1990. A multicenter protocol study including the 7 hospitals attending almost the entire population of Cadiz was conducted and the diagnosis of AIDS was undertaken according to the 1987 CDC criteria. The Kaplan and Meier actuarial method was used for the survival study. Prevalence was as follows: 10 cases in 1986 37 in 1987 61 in 1988 121 in 1989 and 40 during the 1st 5 months of 1990. Males dominated (84%) and the mean age was 28.6 years. The predominant risk factor was parenteral drug abuse (84%) with signs of social unacceptance (unemployment 70% and 68% with prison records). 38% of the patients were no longer drug addicts at the time of diagnosis. The number of females who acquired the disease through heterosexual transmission has increased over the last 2 years (13 cases). Opportunistic infections made up 93% of the diagnostic criteria with esophageal candidiasis (EC 45%) and extrapulmonary tuberculosis (ET 34%) being the most frequent. The probability of survival was 14% at 35 months; when ET was the exclusive diagnostic criterion survival was higher (30% vs. 9%) and the mean of T4 lymphocytes in this group was higher (228 vs. 154). All were statistically significant. AIDS is a serious progressive problem for the Public Health Department in the province of Cadiz and predominantly affects parenteral drug addicts at a higher % than other Spanish series in socially unaccepted people. The increase in females with AIDS from heterosexual transmission is worrisome. EC and ET are the most verified diagnostic criteria. The prognosis remains poor for the shortterm with survival increasing for those patients with ET as the exclusive criterion due to lesser cellular immunodeficiency. (authors modified) (summaries in SPA ENG)