[HIV infection in the adult: epidemiological changes over 25 years (1983-2008) in an area of the Community of Madrid].

Objective: To describe the epidemiological characteristics and evolution of a cohort of HIV-infected patients in Madrid (Spain) over a period of 25 years.

Methods: Longitudinal, prospective, cohort study of all patients diagnosed with HIV infection seen at the Hospital de Móstoles (1983-2008).

Results: Of the 2156 patients attended, 73% were men. In 68%, the route of infection was illicit drug use. There was a peak of new diagnoses in 1991 (188 patients) and a subsequent gradual decline. Sexual transmission increased over the time period studied, with a higher rise in heterosexual transmission. The percentage of immigrants with the infection also increased (more than 60% in the last 3 years). Sub-Saharan Africa remains the predominant region of origin of our immigrant patients. Over the period studied, 5% of patients were diagnosed during the acute infection, and 20% to 30% were diagnosed with AIDS within 1 year after detection of HIV infection. The estimated rate of new diagnoses of HIV infection in 2006 was 195 per million population (pmp), 269 pmp in men and 121 pmp in women.

Conclusions: Many changes have occurred in the epidemiology of HIV infection in our area in the last 25 years. Routine serologic testing without waiting for warning signs would have an impact on early diagnosis and improving the prognosis of these patients.