Analysis of the clinical complexity of people living with HIV based on the GeSIDA stratification system

IF 2.2 4区医学 Q3 INFECTIOUS DISEASES

Enfermedades infecciosas y microbiologia clinica Pub Date : 2026-03-01 Epub Date: 2026-02-24 DOI:10.1016/j.eimc.2026.503135

Julia Barrado Cuchillo , Adrián Valls Carbó , María José Núñez Orantos , Noemí Cabello Clotet , Juncal Pérez-Somarriba Moreno , Ana Muñoz Gómez , Carolina Olmos Mata , Virginia Víctor Palomares , Vicente Estrada Pérez

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引用次数: 0

Abstract

Introduction

Thanks to improvements in antiretroviral therapy (ART), HIV infection has become a chronic disease in developed countries. The stratification of the complexity of chronic patients is a procedure used in other diseases that allows for identifying the risk level of patients and organizing care based on their characteristics.

The objective of this study is to analyze the complexity of a large cohort of people living with HIV (PLWH) on ART and in regular follow-up consultations.

Methods

Descriptive study of complexity according to the GeSIDA stratification scale (GSS), which includes social aspects, risk behaviors, comorbidities, psychological and cognitive status, and viral control in a cohort of PLWH on ART. Patients were classified as extreme, high, medium, or low complexity based on their GSS score.

Results

A total of 1127 patients were included, 83.7% male, with a mean age of 48 years (SD: 13.10). 65.3% had low complexity, 18.5% medium, 8.3% high, and 7.9% extreme complexity. The most determining factors for higher complexity on the GSS were lower social support, drug use and risky sexual behaviors. Female sex, lower educational level, history of AIDS, a lower CD4 count and a lower CD4/CD8 ratio were associated with higher complexity.

Conclusions

The GSS identifies most PLWH on ART as low complexity. There are clinical factors associated with greater complexity, suggesting that there are subgroups of PLWH who should receive differentiated clinical care to prevent complications and improve their quality of life.

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基于GeSIDA分层系统的HIV感染者临床复杂性分析

由于抗逆转录病毒疗法（ART）的改进，艾滋病毒感染在发达国家已成为一种慢性病。慢性病人复杂情况的分层是一种用于其他疾病的程序，它允许确定病人的风险水平，并根据他们的特点组织护理。本研究的目的是分析一大群艾滋病毒感染者（PLWH）接受抗逆转录病毒治疗和定期随访咨询的复杂性。方法采用GeSIDA分层量表（GSS）对接受抗逆转录病毒治疗的PLWH患者进行复杂性描述性研究，包括社会方面、危险行为、合并症、心理和认知状况、病毒控制等。根据患者的GSS评分将患者分为极端、高、中、低复杂程度。结果共纳入1127例患者，其中男性83.7%，平均年龄48岁（SD: 13.10）。65.3%为低复杂性，18.5%为中等复杂性，8.3%为高复杂性，7.9%为极端复杂性。导致GSS复杂性升高的最主要因素是社会支持程度低、吸毒和高危性行为。女性、低教育水平、艾滋病史、较低的CD4计数和较低的CD4/CD8比值与较高的复杂性相关。结论GSS将大多数抗逆转录病毒治疗的PLWH识别为低复杂性。有临床因素与更大的复杂性相关，这表明有不同的PLWH亚群，他们应该接受差异化的临床护理，以预防并发症和改善他们的生活质量。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Enfermedades infecciosas y microbiologia clinica 医学-传染病学

CiteScore

2.10

自引率

8.00%

发文量

194

审稿时长

29 days

期刊介绍： Hoy está universalmente reconocida la renovada y creciente importancia de la patología infecciosa: aparición de nuevos agentes patógenos, de cepas resistentes, de procesos con expresión clínica hasta ahora desconocida, de cuadros de una gran complejidad. Paralelamente, la Microbiología y la Infectología Clínicas han experimentado un gran desarrollo como respuesta al reto planteado por la actual patología infecciosa. Enfermedades Infecciosas y Microbiología Clínica es la Publicación Oficial de la Sociedad Española SEIMC. Cumple con la garantía científica de esta Sociedad, la doble función de difundir trabajos de investigación, tanto clínicos como microbiológicos, referidos a la patología infecciosa, y contribuye a la formación continuada de los interesados en aquella patología mediante artículos orientados a ese fin y elaborados por autores de la mayor calificación invitados por la revista.