CHARACTERIZATION OF THE CLINICAL PROFILE AND NATURAL-HISTORY OF HIV-INFECTION - STUDY IN A CHILEAN POPULATION FOLLOWED AT A PILOT MULTI-PROFESSIONAL CENTER

Four hundred and eighty six infected adults (90,7% men) were prospecti vely followed from 1988 to 1993 at a multiiprofessional center in Sant iago, Chile. 87,8% of male patients (pts) -84% of them homo/bisexual- and 64,4% of women acquired the infection sexually. At the beginning o f the follow up (F/U) 51% of men and 72% of women were asymptomatic an d 30% of the the total group had AIDS. (AIDS definition: CDC 1993, exc luded CD4 lymphocyte count < 200 x mm3). 240/486 (49,4%) had developed AIDS at the end of the study (12/31/93). AIDS defining events (ADE) w ere: interstitial pneumonia (confirmed or suggestive as caused by P. c arinii [PCP]), 25%, tuberculosis (all forms), 22,1%; wasting, 13,8%; K aposi Sarcoma, 9,2%; esophageal candidiasis. 6,7% isospolinsis, 5,4%. Of all PCP cases, 72% were ADE, the rest, post AIDS'. As expected, AID S pts continued having major complications (mainly bacterial pneumonia s, PCPs, esophagitis, tuberculosis and diarrhea due to I. belli and Cr yptosporidium, Less frequently, but also observed, were toxoplasmic en cephalitis and cryptococcal meningitis). Known mortality (excluded aba ndonment of F/U) was 27% for the whole group and varied from 5,8%, 51, 6% to 69,2% for the first, 4th and 6th year of F/U respectively. For I I-Ill CDC pts the mortality was 5% and 57% and for IV CDC pts it was 3 8% and 100% during the first and 6th year of F/U respectively,. 36%, 5 3%, 74% and 85% of the pts followed for 1, 3, 5 and 6 years respective ly had developed AIDS by the end of 1933. Multifactoral causes with ei ther diarrhea, wasting or both were responsible for the death in half the pts in whom this was known, 15% died of respiratory complications and 5,7% of cryptococcal meningitis. 80% of AIDS pts survived their AD E. This study has provided information about the clinical profile of t he the HIV infection and natural history of the disease in Chile.