[The efficacy of antiretroviral treatment in patients with human immunodeficiency virus infection. A study of 807 patients]. / Eficacia del tratamiento antirretroviral en pacientes con infección por el virus de la inmunodeficiencia humana. Estudio de 807 pacientes.

BACKGROUND: The natural history of HIV infection and its related diseases has changed after the introduction of new potent antiretroviral therapies (HAART). We have performed this study to analyse in our hospital the natural history of HIV infection in relation to the therapeutics advances. PATIENTS AND METHODS: We have exhaustively revised the clinic records of all the 807 adult HIV-infected patients followed at the HUC from January 1985 to December 1999. RESULTS: The incidence of most opportunistic diseases, new AIDS cases, hospital admissions and deaths decreased as from 1997. Patients who started antiretroviral therapy with HAART had lower incidence of AIDS, hospital admissions and deaths than patients with other therapy modalities. Survival of patients placed on HAART was better than that of patients who received different therapy modalities (p < 0.001), independently on the intensity of immunosuppression and AIDS diagnosis. Multivariate analysis showed that HAART therapy was the best protector factor, decreasing the risk of progression to death (p < 0.001). CONCLUSIONS: HAART therapy leads an important improvement of survival of HIV infected patients, independently an the intensity of immunosuppression and slows HIV progression, decreasing the number of new AIDS cases, hospital admissions and deaths.

[Changes of liver enzymes during severe infections]. / Alteración de las enzimas hepáticas en el curso de infecciones graves.

To establish the prevalence of liver enzyme alterations in the course of serious infections of diverse origin, 112 patients were studied retrospectively for the levels of GOT, GPT, LDH, GGT, alkaline phosphatase (FA) and bilirubin (BIL). Cases in which the values might be altered due to causes other than the infectious process were previously excluded. The prevalence of affectation of each of the parameters was the following: GGT, 39.1%; LDH, 33.3%; FAL, 30.1%; GOT, 29.5%; GPT, 24.8%; BIL, 18.3%. Seventy percent had at least one of these values changed. No significant differences were found in the incidence or intensity of the analytic alterations in function of the origin of the of infection, which suggests that these modification are nonspecific. Bilirubin levels were found to be significantly higher in the patients who died. On realizing the linear correlation analysis between the diverse parameters studied, a good correlation was found between them, suggesting a common pathogenetic mechanism.