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Abstract
Changing scenario of HIV disease: the increase of AIDS presenters
Manfredi R.1, Calza L.1, Chiodo F.1
Introduction: Notwithstanding the introduction of HAART since mid-1996, AIDS still occurs, mostly in patients (p) who missed-neglected their HIV serostatus.
Methods: A prospective observational study of all AIDS cases notified in the period 2001-2003 was carried out. Epidemiological-clinical correlates of newly diagnosed AIDS were compared with those of all AIDS notifications performed in the pre-HAART decade (1985-1995).
Results: Compared with the pre-HAART period, a significant drop of p with newly diagnosed AIDS occurred (from 58.3±11.2/year in the period 1986-1995, to 18.3±7.9/year during the last three years;p<.001), with an increase of patient’s age (p<.003), and the female gender (p<.03). An increase of sexual transmission vs i.v. drug abuse (p<.001), and an increased proportion of non-Italian p (p<.04) was found. After HAART introduction, a dramatic drop of opportunistic infections involved diseases linked to a very low CD4+ lymphocyte count, while a proportional increase of lymphomas, tuberculosis, and bacterial pneumonia remained of concern. However, both pneumocystosis and esophageal candidiasis ranked first in frequency in both time periods, followed by neurotoxoplasmosis, wasting syndrome, and AIDS-dementia complex. The absolute number and the proportion of p with multiple concurrent AIDS-defining diseases increased just in the HAART era, as well as AIDS cases notified at the time of death (p<.001), while HIV-associated immunodeficiency at AIDS diagnosis did not prove different. Suprisingly, prior anti-HIV therapy proved more common among diagnoses made until 1995, versus those identified during years 2001-2003 (p<.001), since a diagnosis of AIDS was increasingly made concurrently with HIV serodiagnosis.
Conclusions: Clinicians who face p at risk for opportunism should continue to consider advanced, but still undiagnosed AIDS in their differential diagnosis, in order to ensure prompt recognition and adequate management of p who did not take any benefit from HAART, due to a missed or neglected HIV disease.
The 3rd IAS Conference on HIV Pathogenesis and Treatment
Abstract no.
TuPe7.8C02
Suggested Citation
"ManfrediR., et al.
Changing scenario of HIV disease: the increase of AIDS presenters.
Poster Exhibition:
The 3rd IAS Conference on HIV Pathogenesis and Treatment:
Abstract no.
TuPe7.8C02"
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