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array:22 [ "pii" => "S0025775300716630" "issn" => "00257753" "doi" => "10.1016/S0025-7753(00)71663-0" "estado" => "S300" "fechaPublicacion" => "2000-01-01" "aid" => "71663" "copyright" => "Elsevier España, S.L.. Todos los derechos reservados" "copyrightAnyo" => "2000" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Med Clin. 2000;115:681-6" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 12559 "formatos" => array:3 [ "EPUB" => 7 "HTML" => 12244 "PDF" => 308 ] ] "itemSiguiente" => array:18 [ "pii" => "S0025775300716642" "issn" => "00257753" "doi" => "10.1016/S0025-7753(00)71664-2" "estado" => "S300" "fechaPublicacion" => "2000-01-01" "aid" => "71664" "copyright" => "Elsevier España, S.L." "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Med Clin. 2000;115:687-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 2730 "formatos" => array:3 [ "EPUB" => 6 "HTML" => 2489 "PDF" => 235 ] ] "es" => array:10 [ "idiomaDefecto" => true "titulo" => "Prevalencia y repercusión clínica de la deficiencia de inmunoglobulina A en la enfermedad celíaca" "tienePdf" => "es" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "687" "paginaFinal" => "689" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Clinical relevance of immunoglobulin A deficiency in celiac disease" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:2 [ 0 => array:2 [ "autoresLista" => "José Sardi, Francesc Casellas, Juan Ramón Malagelada" "autores" => array:3 [ 0 => array:2 [ "nombre" => "José" "apellidos" => "Sardi" ] 1 => array:2 [ "nombre" => "Francesc" "apellidos" => "Casellas" ] 2 => array:2 [ "nombre" => "Juan" "apellidos" => "Ramón Malagelada" ] ] ] 1 => array:2 [ "autoresLista" => "Inés de Torres" "autores" => array:1 [ 0 => array:2 [ "nombre" => "Inés" "apellidos" => "de Torres" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775300716642?idApp=UINPBA00004N" "url" => "/00257753/0000011500000018/v1_201307291652/S0025775300716642/v1_201307291652/es/main.assets" ] "es" => array:14 [ "idiomaDefecto" => true "titulo" => "El período de incubación del sida en España antes de la terapia antirretroviral de alta eficacia" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "681" "paginaFinal" => "686" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "I. Hernández-Aguado" "autores" => array:2 [ 0 => array:3 [ "nombre" => "I." "apellidos" => "Hernández-Aguado" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:1 [ "colaborador" => "GEMES (Grupo Espa ñol Multicéntrico para el Estudio de Seroconversores)" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "Correspondencia: Dr. I. Hernández-Aguado. Departamento de Salud Pública. Facultad de Medicina. Universidad Miguel Hernández. Campus de San Juan. Carretera de Valencia, km 87. San Juan de Alicante. 03550 Alicante." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "AIDS incubation period in Spain before highly active antiretroviral therapy" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2000-05-10" "fechaAceptado" => "2000-10-10" "PalabrasClave" => array:1 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec222550" "palabras" => array:3 [ 0 => "Seroconverters" 1 => "Natural history" 2 => "HIV progression" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Fundamento</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Para evaluar el impacto de las nuevas terapias antirretrovirales en la progresión de la infección por el virus de la inmunodeficiencia humana (VIH) es necesario conocer la situa-ción previa a su introducción. En España, hasta el momento no hay datos sobre el período de incubación del sida en todas las categorías de transmisión.</p> <span class="elsevierStyleSectionTitle">Sujetos y método</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se analizaron los datos de seis cohortes de sujetos VIH positivos con fechas de infección por el VIH documentadas (seroconversores) identificados desde 1982, mediante métodos de Kaplan-Meier con entrada retardada, regresión de Cox y regresión logarítmica normal.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">De los 820 sujetos analizados, el 80,34% eran varones; el 57%, usuarios de drogas por vía parenteral; el 22%, homosexuales, y el 21% estaba afectado de hemofilia. La mediana de edad a la seroconversión fue de 25 años; la mediana del año de seroconversión fue 1991, y la mediana de seguimiento fue 4 años (rango, 0-14,59). El período de incubación del sida hasta diciembre de 1996 fue de 10 años. Sólo la edad (riesgo relativo [RR] 1,026; intervalo de confianza [IC] del 95%, 1,005-1,047) y el sexo (RR, 0,58; IC del 95%, 0,35-0,99) se asociaron de forma estadísticamente significativa a la progresión del sida, sin observarse un efecto del año de calendario.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La progresión a sida en España hasta 1996 y el efecto de la edad son similares a otras cohortes europeas y no se observa un efecto del año de calendario. Esto refleja que las in-tervenciones terapéuticas, en el contexto de los ensayos clínicos que miden la eficacia, no se traducen necesariamente en mejoras en el ámbito poblacional. Es preciso el seguimiento de las cohortes de seroconversores para evaluar el impacto de las nuevas terapias.</p>" ] "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Background</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To evaluate the impact of new antiretroviral therapies on progression of HIV infection, is necessary to know what was the situation before their introduction. In Spain, no data on the incubation period of AIDS from all transmission categories have been available so far.</p> <span class="elsevierStyleSectionTitle">Subjects and method</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Data from 6 well established seroconverter cohorts with well documented times of HIV seroconversion (presence of an HIV negative test) identified from 1982 to current date were analysed using Kaplan-Meier methods, allowing for late entry, Cox regression and log-normal regression.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Of the 820 individuals analyzed, 80.34% were men, 57% intravenous drug users, 22% homosexual and 21% haemophilics. Median age at seroconversion was 25 years; median seroconversion year was 1991 and median follow-up was 4.11 years (range, 0-14.59). The incubation period of AIDS up to December 1996 was 10 years; only age at seroconversion relative risk [RR], 1.026; 95% CI, 1.005-1.047) and gender (RR, 0.58; 95% CI, 0.35-0.99) were associated with progression to AIDS with no effect of calendar year.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Progression estimates to AIDS in Spain up to 1996 are similar to other European cohorts, so is the age effect, with no calendar year effect up to that date. This shows how therapeutic interventions measured in clinical trials, which measure efficacy, do not necessarily translate in improvements at the population level, supporting the need to follow seroconverter cohorts to evaluate impact of new antiretroviral therapies.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Referencias Bibliográficas" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:31 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Natural history of human immunodeficiency virus infections in haemophilics: effects of T-cell subsets, platelet counts, and age" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M.E. Eyster" 1 => "M.H. Gail" 2 => "J.O. Ballard" 3 => "H. Al-Mondhiry" 4 => "J.J. 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