Abstract

Clinical presentation of HIV-infection and AIDS in Spain: differences between immigrant and autochthonous populations

B. Roca¹, J. Cosín², P. Domingo³, M.J. Galindo⁴, M.L. García Alcalde⁵, P. Geijo⁶, J. Lopez-Aldeguer⁷, F. Lozano⁸, A. Muñoz⁹, E. Deig¹⁰, E. Ribera¹¹, T. Sanchez¹², I. Suárez-Lozano¹³, R. Teira¹⁴, A. Terrón¹⁵, A. Vergara¹⁶, P. Viciana¹⁷, F. Vidal¹⁸, J. Muñoz¹⁹, V. Estrada²⁰, T. Puig²¹, M.A. Castaño²², E. Pedrol²³, M. Garrido<sup>24

1</sup>Hospital General of Castellon, University of Valencia, Castellón, Spain, ²H. Gregorio Marañon, Madrid, Spain, ³H. S. Creu i S. Pau, Barcelona, Spain, ⁴H. Clinico, Valencia, Spain, ⁵H. de Cabueñes, Asturias, Spain, ⁶H. V de la Luz, Cuenca, Spain, ⁷H. La Fe, Valencia, Spain, ⁸H. de Valme, Sevilla, Spain, ⁹H.I. Cristina, Badajoz, Spain, ¹⁰H General, Granollers, Spain, ¹¹H. Vall D´hebron, Barcelona, Spain, ¹²H. V. del Rosell, Cartagena, Spain, ¹³H. I. Elena, Huelva, Spain, ¹⁴H Torrelavega, Torrelavega, Spain, ¹⁵H. SAS, Jerez, Spain, ¹⁶H. Clinico Puerto Real, Cadiz, Spain, ¹⁷H. V. del Rocío, Sevilla, Spain, ¹⁸H. Joan XXIII, Tarragona, Spain, ¹⁹H. de Basurto, Bilbao, Spain, ²⁰H. Clinico San Carlos, Madrid, Spain, ²¹H. Arnau de Vilanova, Lerida, Spain, ²²H. Carlos Haya, Málaga, Spain, ²³Xarxa Social i Sanitaria Santa Tecla, Tarragona, Spain, ²⁴Data Management AM-VACH, Huelva, Spain

Background: Information regarding epidemiology and clinical presentation of HIV-infection and AIDS in the immigrant population in Spain is scant.
Methods: Prospective multicenter study, based on the electronic database of the Spanish VACH Cohort, a project participated by 23 hospitals throughout
the country. We assess sociodemographic and HIV-infection-related data in the patients of the Cohort, and compare results of the immigrant with those of the autochthonous populations with nonparametric tests.
Results: We include 14,499 patients, 84.1 % are Spaniards and 15.9 % natives from other countries: 165 (1.1 % of the total) from Nigeria, 163 (1.1 %) from Ecuador, 160 (1.1 %) from Colombia, 138 (1.0 %) from Argentina, 134 (0.9 %) from Portugal, and 131 (0.9 %) from Brazil.
Table 1 shows results that refer to the first two visits, except for AIDS and follow-up data that refer to the whole study period. Values are medians when not otherwise specified.

	Immigrant	Autochthonous	P
Age, years	33.3	36.1	< 0.001
Gender male, %	68.7	76.7	< 0.001
HIV-risk factor, drug use, %	10.6	48.5	< 0.001
HIV-risk factor, MSM, %	31.4	17.9	< 0.001
HIV-risk factor, heterosexual, %	49.0	24.5	< 0.001
CD4 cell count, per mm3	320	308	0.176
HIV RNA, copies per ml	26,915	26,303	0.491
AIDS cases, %	22.6	29.5	< 0.001
Follow-up, months	22.1	47.0	< 0.001

[1]

Tuberculosis was the most common AIDS-defining condition both in the immigrant and the autochthonous population, and Pneumocystis pneumonia was the second in both populations.
Conclusions: Sociodemographic features and risk factors for HIV-infection are different in the immigrant and the autochthonous populations of Spain, while most characteristics of HIV disease are similar in both groups.