Naslov
The changing trends in presentation of clinical AIDS in Croatia: 2001 to 2017

Autori
Lutchmun, Wandini ; Lukas, Davorka ; Romih Pintar, Vanja ; Zekan, Šime ; Begovac, Josip

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Skup
29th ECCMID 2019

Mjesto i datum
Amsterdam, Nizozemska, 13.04.2019. - 16.04.2019

Vrsta sudjelovanja
Predavanje

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
Trends ; AIDS ; Croatia

Sažetak
Background: All HIV-infected persons in Croatia (population: 4.2 million) are treated at one center, the University Hospital of Infectious Diseases (UHID), Zagreb. The aim of this study was to assess the population trend in presentation to care with AIDS-defining conditions (ADC) and to describe whether there was a change in the type of the presenting ADC in the period 2001-2017. Materials/methods: The data were extracted form the electronic databaseat UHID. Included into the study were Croatian citizens or permanent residents whose first ever presentation to HIV care was with an ADC. The population trend over time was analyzed by annual percent change (APC) using the Joinpoint program. ADC were compared over 3 periods (2001-2006, 2007-2012, 2013-2017) with thechi-squaretest for trend. Results: Of 1174 persons who never received HIV care before elsewhere, 240 (20.4%, median age:42.6 years) presented with and ADC. The rate of ADC per one million inhabitants was low (1.6 to 4.7) ; it increased (APC=2.8%, p=0.058) over time, particularly in males (n=215, APC=3.4%, p=0.017), but remained very low and unchanged in females (n=25, p=0.331) (Figure). The proportion of persons with ADC among all first-time receivers of HIV care declined from 18.0% in 2001 to 12.1% in 2017 (p=0.011).There was an increasein the proportion of males (period 2001-06: 58/70, period 2013-17: 75/84 ; p-trend=0.039) and MSM (period 2001-06: 28/70, period 2013-17: 69/84 ; p- trend<0.001) presenting with ADC. The most common ADC (total=316) were Pneumocystis pneumonia (PCP ; n=91), tuberculosis (TB ; n=47), esophageal candidiasis (n=28) and Kaposi’s sarcoma (KS ; n=26). There was a nonsignificant increase in the proportion of cases with PCP (23/70 in the period 2001-06 versus 37/84 in the period 2013-17 ; p-trend=0.149), where as TB was less frequent (p- trend=0.001) and KS was more frequent (p- trend=0.014) in recent years. 31(12.9%) persons died within 6-months and 39 (16.3%) within 12- months of AIDS-diagnosis (p-trend=0.212 and 0.552 respectively). Conclusions: There was an increasing trend in presentation with ADC, however, it is encouraging that the proportion of presentations with ADC decreased over time. Presentation with TB declined, where as with KS increased. Further efforts to decrease the number of AIDS- presentations are needed.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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