Background: To analyze the evolution of the mortality and survival of AIDS patients in Barcelona.
Methods: In the mortality study patients living in the city and who were detected from 1981-1991 by an active surveillance system were included. The survival analysis was restricted to patients from 1988-1990 (same definition of AIDS and longer patient follow up). The Kaplan-Meier and Cox methods were used.
Results: In 1991 the rate of mortality was 14.1/100,000, similar to 1990 (14.0/100,000) and greater or much higher than the preceding years. Lethality increased in agreement with the semester of case diagnosis, with values between 100% (first years of the epidemic) and 23% (last semester) being registered. The accumulated probability of survival at 365 days was of 65.2% (CI 95%, 62.2-68.0) and 32.2% (CI 28.8-35.7) at 1.095 days. Median survival of the whole population was 669 days. Statistically significant differences were observed according to the year of diagnosis, prison history, antiretroviral treatment, disease diagnosis, transmission group, district of residence and age group but not according to sex. Multivariate analysis only discarded the influence of prison history.
Conclusions: Mortality by AIDS has enormously increased. Survival analysis demonstrated better prognosis in the youngest cases, those residing in more favorable socioeconomic districts, diagnoses from diseases added to the old definition of AIDS, the IVDA and homosexual risk groups and the most recently diagnosed cases.