Abstract

A hospital-based surveillance system of infection by the human immunodeficiency virus (HIV) has been implemented in nine wards of the Bordeaux University Hospital by the Groupe d'Epidémiologie Clinique du SIDA en Aquitaine (GECSA). The aim was to systematically collect clinical, biological and epidemiological data on HIV-infected patients who were followed by physicians from the participating hospitals. The analysis of the data at enrollment was performed on the 1,242 patients whose infection was diagnosed between January 1983 and December 1989. The male to female ratio was 2.5:1 and the proportion of women has increased over time. For men, 39.8% were homosexual or bisexual, 36.9% were intravenous drug users (IVDU's) and 2.6% had both risk behaviours. For women, the most frequently reported high-risk behaviour was IVDU (50.3%), followed by heterosexual contacts with an HIV-infected or at-risk person (HET) (28.6%). The distribution of risk behaviour has changed over time, with an increase in the proportion of HET and a decrease in the proportion of IVDU's for both sexes. The proportion of patients included that fulfilled the definition for AIDS was 18.9%. Based on this system, the incidence rate of diagnosis of HIV infection in the Aquitaine region, regardless of the clinical stage of the infection was estimated to be at least 63.4 per million inhabitants and per year in 1988-1989. The GECSA surveillance system points out some of the specificities of the progression of the HIV epidemic in the Aquitaine region.(ABSTRACT TRUNCATED AT 250 WORDS)