HIV in Portugal · HIV in Portugal Catarina Oliveira Paulo, Joana Alves, Liliana Maia, Raquel Duro...
Transcript of HIV in Portugal · HIV in Portugal Catarina Oliveira Paulo, Joana Alves, Liliana Maia, Raquel Duro...
HIV in Portugal
Catarina Oliveira Paulo, Joana Alves, Liliana Maia, Raquel Duro
EACS HIV Summer School 2016
HIV Epidemiology
8,9 cases*/100.000(IC 95%: 13,3-14,8)
Ratio ♂/♀ 2,6
6 new cases < 15 years old
2014
Portugal remains the country in Western Europe with the higher rate of new diagnoses
Data from the last annual report of the INSA, published in October of 2015
52.694 diagnosed patients
20.856 AIDS stage cases
10.377 deaths
1983-2014
Num
bero
fcas
es
HIV infetion casesAIDS casesDeaths
The peak was at the end of the 90s, since then the numberof new cases has fallen
The mean age at the time of the diagnosis has increased, except in the group of MSM
We still have a considerable percentage of diagnoses in an advanced stage of the disease (18,3% in 2014)
• 2264 notified cases(2080 newly diagnosed) » decreasing
• Oporto, Lisbon, Setúbal and Algarve » intermediateincidence (> 20/100.000 and < 50/100.000)
• Male 63,4%; median age 48,5 (84,1% born in Portugal)
• HIV status knowned in 74,3% » 13,3% HIV positive
• 24,6% had social risk factors: alchoolism (11%) and ilicitdrug abuse (9,9%)
• Pulmonary Tb most common (71,3%)
• 23 cases of multirresistant Tb; 6 extensively resistant Tb
31st of December 2014
HIV and Tuberculosis (Tb)
• 1735 notified cases of HIV-2 infection - 3,3% of total
• 656 co-infection HIV-1 and HIV-2 –1,2% of total
• No predominant sex • Heterossexual transmission mainly• 52,8% live in Lisbon – 51,9%
originally from subsaharian Africa
• Former colonial ties with Western Africa
HIV-2
Costs with HAART
26 600 000
26 800 000
27 000 000
27 200 000
27 400 000
27 600 000
27 800 000
28 000 000
28 200 000
28 400 000
175000000
185000000
195000000
205000000
215000000
225000000
235000000
2011 2012 2013 2014
Num
ber o
f pa
ckag
es
Cost
s (E
uros
)
Year
Despite the higher number of treatments, we achieve a reduction
in the costs in the two last years
Data from the last report of the DGS about HIV infection, AIDS and tuberculosis in Portugal – published in 2016
HIV/AIDS in Portugal
Diva TrigoMD, Infectious Diseases ResidentHospital Prof. Dr. Fernando Fonseca, Lisbon
EACS HIV Summer School 2016
Country of origin
ImmigrantsPortuguese
17,1%
Geographic distribution
Oporto
Coimbra
Lisbon
Algarve
Subsarian AfricaLatin AmericaEuropean UnionEast EuropeOther
1220 new HIV diagnoses in 2014
44,3%
18,5%
4,4%
5,7%
Dire
ção
Ger
al d
e Sa
úde,
Infe
ção
por V
IH, S
IDA
e Tu
berc
ulos
e em
núm
eros
, 201
5
Heterosexual (non-generalized epidemics) Heterosexual (generalized epidemics)IV drug useMSM
Mode of transmission
Mother-to-child transmission
1,7%
NoYes
239 babies bornto HIV+ mothers
CD4+ count at diagnosis
31%<200 cells/uL
≥200 cells/uL
1220 new HIV diagnoses in 2014
2004 2014
Dire
ção
Ger
al d
e Sa
úde,
Infe
ção
por V
IH, S
IDA
e Tu
berc
ulos
e em
núm
eros
, 201
5
30956 HIV-infected patients under follow-up in 2014
5827513
2026
14968
3527
1743
597
2761 HIV-patients
3,1%
HIV-1HIV-2
ABC
Geographic distribution HIV type
CDC HIV stage
25,2%
Dire
ção
Ger
al d
e Sa
úde,
Infe
ção
por V
IH, S
IDA
e Tu
berc
ulos
e em
núm
eros
, 201
5
Portuguese HIV treatment recommendations (2015)
Prog
ram
a N
acio
nal p
ara
a in
feçã
oVI
H/SI
DA, R
ecom
enda
ções
Por
tugu
esas
para
o tr
atam
ento
da
infe
ção
por V
IH-1
e V
IH-2
, 201
5
“A TARc está recomendada a todos os doentes com infeção crónica por VIH-1 com CD4+ ≤ 500 células/µl”
“ART should always be recommended irrespective of the CD4 count “
HIV/AIDS in Portugal
Diva TrigoMD, Infectious Diseases ResidentHospital Professor Doutor Fernando Fonseca, Lisbon
EACS HIV Summer School 2016
Thank You