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J Castilla

Publications and source records attributed to J Castilla.

At least 37 records · Page 2Linked to original sources
PubMed2001

Time trend in incidence of HIV seroconversion among homosexual men repeatedly tested in Madrid, 1988--2000.

An open cohort of 2670 homosexual men repeatedly tested for HIV at a Madrid clinic has registered 8050 person-years (PY) of follow-up and 157 seroconversions from 1988 to 2000. After declining from 1988 (4.71 per 100 PY), the incidence rate began a significant upward trend, reaching a figure of 2.16 per 100 PY in 2000. These findings ought to alert surveillance systems and prevention programmes.

AIDS Serodiagnosis↗
PubMed2001

Monitoring the response to antiretroviral therapy in HIV-1 group O infected patients using two new RT-PCR assays.

Failure to recognise infection caused by human immunodeficiency virus type 1 (HIV-1) group O variants has been described using both serological and genetic procedures. Moreover, monitoring the response to antiretroviral therapy is a difficult task in patients infected with HIV-1 group O since commercial tests are not available so far for the quantitation of this virus. In this study, the virological response to antiretroviral therapy were assessed in five HIV-1 group O-infected patients living in Spain by using two new and different RT-PCR methods (MUPROVAMA and LCx). Twenty-four plasma samples belonging to these five patients were selected. As reference, p24 antigenaemia levels and CD4+ cell counts were used. All samples yielded positive viral load values using MUPROVAMA (range: 138 to 595,500 HIV-RNA copies/ml) and 23 of 24 using LCx (range: < 178 to 98,356 HIV-RNA copies/ml). Overall, the results obtained using both assays showed a good correlation among themselves, and in respect to p24 antigenaemia and CD4+ cell counts. However, the values provided by LCx were significantly lower (0.33 logs on average) than those provided by MUPROVAMA. In conclusion, both the highly sensitive MUPROVAMA and LCx Quantitative assays might represent an useful tool for guiding the decision on when start treatment and for monitoring the response to antiretroviral therapy in HIV-1 group O-infected patients.

Adolescent↗
PubMed2001

Sociodemographic characteristics and HIV risk behaviour patterns of male sex workers in Madrid, Spain.

This paper describes the sociodemographic and work characteristics, prevalence of HIV infection and associated risk behaviours among male sex workers (MSWs) in Madrid (Spain). Using an anonymous semi-structured questionnaire, educators attached to a mobile unit under a street-based prostitution programme surveyed 84 MSWs from several Madrid areas. Of the total surveyed: 35% were immigrants, mean age was 23 years, mean period in prostitution was four years; 21% had no primary education; 16% had injected drugs at some time; 11% reported private sexual relationships exclusively with women; 89% always used condoms in anal practices with clients; and 41% were in sexual relationships with their partners. Only 11% had ever used fortified condoms. In the preceding month, 37% had experienced condom failure, 82% without having used any lubricant. In all, 67% reported having undergone HIV testing, with a higher percentage of positive results among injecting (60%) versus non-injecting drug users (17%). Immigrants had a lower level of education, made less use of condoms, had more condom failures and, in their private lives, a greater proportion reported sexual relationships exclusively with women. In Spain, MSWs should be included in HIV prevention programmes, which ought to be specifically adapted to immigrants. Priority should be given to reducing the condom failure rate in anal intercourse, by improving access to fortified condoms.

Adolescent↗
PubMed2000

[Trend of HIV seroprevalence among mothers of new-born infants from 1996 to 1999].

BACKGROUND: To analyze the evolution of HIV prevalence in mothers of Spanish new-borns. SUBJECTS AND METHOD: Unlinked anonymous testing of HIV in blood spots for detection of metabolic diseases of all new-borns in 1996-1999 in seven regions: Baleares, Canarias, Castilla-La Mancha, Castilla y León, Galicia, Melilla and Murcia. HIV antibody detection was done with ELISA and confirmation with a immunoblot. RESULTS: The prevalence of HIV antibodies was 0.99 per 1,000 in 1996, 1.29 in 1997, 1.42 in 1998 and 1.54 in 1999. There was an upward trend both in the global sample (p = 0.0015) and in those from Canarias (p < 0.0001) and Castilla y León (p = 0.0389). The prevalence of HIV-1 for the whole period was 1.31 per 1.000 and of 1.13 per 100.000 for HIV-2. CONCLUSIONS: There is a need to offer systematic counselling and HIV testing to all pregnant women.

HIV Antibodies↗
PubMed2000

[Trends in the number of human immunodeficiency virus infected persons and AIDS cases in Spain: 1980-1998].

BACKGROUND: To describe the trend in the number of HIV-infected persons and the number of AIDS cases in Spain between 1980 and 1998. SUBJECTS AND METHODS: The following information was used: annual incidence of AIDS taken from the National Registry, AIDS deaths taken from the same registry and from the Registry of Vital Statistics, HIV seroprevalence in studies in sentinel populations, HIV incidence in cohorts of exposed persons, and reports of HIV infections in the registries existing in the autonomous communities. We considered three events of interest--HIV infection, AIDS and death--which were related using back-projection and compartmental models. RESULTS: HIV spread rapidly in Spain during the years 1980. Transmission subsequently declined by more than 50% to figures that probably do not exceed 6,000 new infections in 1998. The incidence of AIDS increased to more than 7,000 new cases in 1994 and has since declined to some 4,000 cases in 1998. The level of AIDS mortality has always been lower than the incidence; it increased up to 1995 and then dropped to less than half in subsequent years. The number of living persons infected with HIV, including AIDS cases, arose until the early years 1990 and has since remained steady at about 125,000 persons. The number of cases of living persons with AIDS has increased continuously, and is estimated at about 19,000 through the end of 1998. CONCLUSIONS: The recent trend in new infections, AIDS cases and deaths is favourable, while the number of infected living persons remains very high.

Acquired Immunodeficiency Syndrome↗
PubMed2000

[Evolution of the new number of diagnoses of HIV infection in Asturias, Navarra and La Rioja].

BACKGROUND: To describe the time-trend of people diagnosed with HIV infection in Asturias, Navarra and La Rioja up to 1998. METHODS: HIV case reports since the beginning of the epidemic have been analysed. Only the first positive confirmed result for each patient was taken into account. RESULTS: In the three regions a total of 7,870 HIV infections had been diagnosed by 1998 (4 cases per 1,000 inhabitants). New diagnoses decreased 60% since 1991 to 1998, with the greatest fall among intravenous drug users, and the lowest fall in sexually transmitted infections. CONCLUSIONS: This time-trend supports a reduction in HIV transmission in these three regions; however, the number of new diagnosed infections remains high.

Female↗
PubMed2000

Seroprevalence of HIV and HTLV in a representative sample of the Spanish population.

HIV and HTLV seroprevalence was determined by means of unlinked anonymous testing of 2144 sera, originally obtained from primary care patients by representative sampling of the Spanish population aged 15-39 years in 1996. HIV-1 seroprevalence was 4.3 per 1000 population in the 15-39 years age group [95% confidence interval (CI), 1.5-10.7] and 5.6 per 1000 (95% CI, 1.8-15.3) in the 20-39 years age group. Seroprevalence proved higher in males and urban residents. No antibodies to HIV-2 and HTLV-I were detected in any of the sera studied. However, presence of antibodies to HTLV-II was confirmed in one serum sample, while HTLV seroreactivity, though detected in another, could not be typed. The two HTLV-positive results equated to a seroprevalence of 1.9 per 1000 in the 20-39 years age group (95% CI, 0.3-8.6). HIV-I seroprevalence was consistent with previous estimates yielded by back-calculation. The level of HTLV seroprevalence found suggests endemicity.

Adolescent↗
PubMed2000

Mycobacterium tuberculosis and human immunodeficiency virus co-infection in intravenous drug users on admission to prison.

BACKGROUND: Intravenous drug users (IDUs) and prisoners are groups of great interest in human immunodeficiency virus (HIV) infection and tuberculosis (TB) epidemiology. AIM: To determine predictors and temporal trends of the co-infection of Mycobacterium tuberculosis and HIV in IDUs on admission to prison. PATIENTS AND METHODS: Between 1 January 1991 and 31 December 1997, 796 IDUs or former IDUs were studied. Socio-demographic and penitentiary variables were evaluated. HIV-positive patients with > or =5 mm induration on tuberculin test were deemed co-infected. Analysis of factors associated with co-infection was based on a logistic regression model. RESULTS: Of the incoming prisoners, 44.0% were infected by M. tuberculosis, 43.8% by HIV and 20.1% were co-infected. Co-infection predictors were: 1) total prison time served previously (none, OR 1; <2 years, OR 2.44, 95% CI 1.28-4.64; > or =2 years, OR 4.94, 95% CI 2.56-9.55); 2) age (16-25 years, OR 1; 25-29 years, OR 3.14, 95% CI 1.71-5.75; >29 years, OR 3.67, 95% CI 1.96-6.86); 3) tattoos (OR 1.56, 95% CI 0.98-2.49), 4) syringe sharing (OR 2.43, 95% CI 1.57-3.77) and 5) ex-IDU status (OR 1.87, 95% CI 1.23-2.82). No statistically significant variation in the annual co-infection tendency was observed (OR 1.10, 95% CI 0.98-1.22). CONCLUSIONS: The high prevalence of co-infection that was detected was associated with risk factors that could be amended by public health intervention.

AIDS-Related Opportunistic Infections↗
PubMed1999

Drug and alcohol consumption and sexual risk behaviour among young adults: results from a national survey.

To study the association of the consumption of alcohol and other psychoactive drugs with sexual risk behaviour for HIV infection, data from a representative sample of the Spanish population aged 18-39 years were analysed. A national household survey was carried out in 1996 using a combination of face-to-face interviews and self-administered questionnaires. The survey included 5253 subjects aged 18-39 years who provided information on alcohol and drug consumption, number of sexual partners and condom use with the steady partner and with casual partners in the 12 months before the survey. Of those surveyed, 27.4% had been drunk at least once and 20.5% had consumed drugs. Both behaviours were associated with male sex, younger age, higher educational level, being single and having had more than one sexual partner. In the logistic regression analysis adjusting for the sociodemographic variables, the greater frequency of drunkenness and cannabis use were associated with having more than one sexual partner. Regular condom use was significantly less frequent among cocaine users and more frequent among opiate users, but was not associated with the use of other drugs. Sexual risk behaviour (i.e. more than one partner and failure to use a condom regularly) was more frequent among persons who had been drunk or used cannabis or cocaine. Excessive consumption of alcohol, and cannabis and cocaine use are independently associated with sexual behaviour involving greater risk of HIV infection or transmission.

Adolescent↗
PubMed1998

[Interrelationship between the duration of HIV infection, viral load and CD4 positive lymphocyte count].

BACKGROUND: The decline in CD4+ lymphocytes occurs at different rates in patients with HIV infection. A longer duration of HIV infection and a higher level of viral replication, represented by the viral load, are associated with a lower CD4+ lymphocyte count. However, the interelationship between these variables is still not well known. PATIENTS AND METHODS: 107 HIV-infected patients for whom the date of infection was known, were included in a transversal study, in which the CD4+ lymphocyte count and the plasma viral load were analysed, the last using an isothermal amplification method (NASBA). Patients were not receiving antiretroviral drugs or suffered intercurrent infections at the time of the study. RESULTS: The mean duration of HIV infection was 8.6 +/- 2.9 years. The mean CD4+ lymphocyte count was 366 +/- 264 x 10(6)/l. The mean plasma viraemia was 4.3 +/- 0.9 logs. In a linear regression model, the CD4+ lymphocyte count was explained in 21.7% of cases by the duration of HIV infection, meanwhile the viral load justified up to 36.2 of CD4+ cell variability. When both parameters were combined, up to 58.4% of CD4+ lymphocyte values were explained. In this model, changes of 1 log in viral load had a 4-fold higher effect on the CD4+ cell count than each year of HIV infection. CONCLUSIONS: The duration of HIV infection and, particularly the viral load strongly influences the current CD4+ lymphocyte count, although other variables should exist (virus with syncytium-inducing phenotype, age of the patient and his immunegenetic repertoire) influencing the different decline seen in CD4+ T-cells.

CD4 Lymphocyte Count↗
PubMed1998

[Incidence and risk factors of the association of AIDS and tuberculosis in Spain].

BACKGROUND: Incidence of tuberculosis in persons coinfected with HIV is very high. The aim of this study was to determine the risk factors for tuberculosis in AIDS patients in Spain. PATIENTS AND METHODS: A study was carried into AIDS cases (1993 European AIDS case definition) over 12 years old, diagnosed in Spain in 1994. A comparison was run between cases with tuberculosis and the remaining reported AIDS cases on the register, by sex, age, transmission category and prison record. Multiple logistic regression was used to assess the independent effect of each variable, with the adjusted odds ratio (ORa) and their 95% confidence intervals. RESULTS: Annual incidence of AIDS and tuberculosis comorbidity was 8.9 per 100,000 inhabitants. Multivariate analysis revealed that tuberculosis in AIDS patients appeared with higher frequency in: males (ORa = 1.4; CI 95%, 1.3-1.6); the 13-29 age group (ORa = 1.3; CI 95%, 1.1-1.5) and the 30-39 year old group (ORa = 1.1; CI 95%, 1.0-1.3), injecting drug users (IDU) (ORa = 1.4; CI 95%, 1.2-1.6), and those patients with a prison record (ORa = 2.1; CI 95%, 1.9-2.4). CONCLUSIONS: In Spain, male AIDS patients, under age 40 years with a prison record and IDU have a higher risk of tuberculosis. Control measures for tuberculosis should therefore be intensified among these patients.

Acquired Immunodeficiency Syndrome↗
PubMed1998

[Trends in human immunodeficiency virus infection prevalence in homosexual/bisexual men in Madrid (1986-1995)].

BACKGROUND: We analysed the trend in seroprevalence for human immunodeficiency virus (HIV) in homosexual or bisexual men who voluntary requested the test in a sexually transmitted disease/HIV clinic in Madrid. PATIENTS AND METHODS: We studied 5,424 homo/bisexual non-injecting drug user (non-IDU) men, who came for the first time since 1986 to 1995. We analysed the HIV seroprevalence taken into account the year, age and exchange of sex by money. A hundred and thirty-six IDU homo/bisexual men were also attended during the same period and they were compared with non-IDU. RESULTS: HIV seroprevalence among the 5,424 non-IDU homo/bisexual men were 20.2%, rising from 19.6% in 1986 to 29.6% in 1990. After then, the trend decreased to 15.3% in 1995 (chi 2 for trend, 66.8; p < 0.0001). Average age was three years higher among seropositives (p < 0.0001), and showed an upward trend from 29.9 in 1986 to 34.6 in 1995 (p = 0.0059). Seroprevalence among homosexuals younger than 25 fell in the last years. One percent of individuals had ever practiced the prostitution. They were younger (average age, 27.6), and their HIV seroprevalence were 25.9%. A hundred and thirty-six IDU homo/bisexual men were also attended for the first time, being 2.4% of overall homo/bisexual men. They had a higher seroprevalence (48.5%) than non-IDU (p < 0.0001), and did not show any significative time-trend. CONCLUSIONS: A favourable evolution can be observed in HIV seroprevalence among homo/bisexual from Madrid, Spain, men who came to be tested, especially among the youngest. Prevention programs should make an effort to maintain this trend.

Adult↗