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1994-09-24
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Document 0745
DOCN M9490745
TI The changing spectrum of AIDS index diseases in Canada.
DT 9411
AU Montaner JS; Le T; Hogg R; Ricketts M; Sutherland D; Strathdee SA;
O'Shaughnessy M; Schechter MT; British Columbia Centre for Excellence in
HIV/AIDS, St Paul's; Hospital, Vancouver, Canada.
SO AIDS. 1994 May;8(5):693-6. Unique Identifier : AIDSLINE MED/94338608
AB OBJECTIVE: To describe the changing spectrum of AIDS index diseases in
Canada over a 10-year period from 1981 to 1991. DESIGN: A descriptive,
population-based study. SETTING: Canada. PATIENTS: All cases of AIDS in
Canada reported by the Division of HIV/AIDS Epidemiology of the
Department of National Health and Welfare. MAIN OUTCOME MEASURES:
Age-standardized rates of initial AIDS manifestations (1987 Centers for
Disease Control and Prevention case definition), by year of diagnosis
among adults in Canada. RESULTS: A total of 6641 adult AIDS cases were
examined. The rate of Pneumocystis carinii pneumonia (PCP) peaked in
1989 with a rate of 3.18 per 100,000, declining to 2.74 per 100,000 in
1991 (P = 0.894). Similarly, the rate of Kaposi's sarcoma (KS)
stabilized during this interval from 1.06 per 100,000 in 1987 to 1.14
per 100,000 in 1991 (P = 0.189). In contrast, the rates of all other
AIDS-defining illnesses increased from 1.48 per 100,000 in 1987 to 3.43
per 100,000 in 1991 (P = 0.001). For these other AIDS index diseases,
significant rate increases were observed for esophageal candidiasis,
cytomegalovirus (CMV) diseases, wasting syndrome, toxoplasmosis, and
Mycobacterium avium complex (MAC) disease. CONCLUSIONS: Our study shows
a leveling and decline in incidence of KS and PCP, respectively, and a
concomitant increase of other diagnoses, especially esophageal
candidiasis, CMV, wasting syndrome, toxoplasmosis, and MAC disease in
Canada. These findings highlight the importance of developing specific
strategies to prevent emerging AIDS index diseases and serve as a
cautionary note to practicing clinicians, indicating the relative
widening of the spectrum of HIV index diseases.
DE Acquired Immunodeficiency Syndrome/COMPLICATIONS/*DIAGNOSIS/
EPIDEMIOLOGY Adolescence Adult AIDS-Related Opportunistic
Infections/*EPIDEMIOLOGY Canada/EPIDEMIOLOGY Candidiasis/EPIDEMIOLOGY
Cytomegalovirus Infections/EPIDEMIOLOGY Esophagitis/EPIDEMIOLOGY
Female Human Incidence Male Middle Age Mycobacterium
avium-intracellulare Infection/EPIDEMIOLOGY Pneumonia, Pneumocystis
carinii/*EPIDEMIOLOGY Risk Factors Sarcoma, Kaposi's/*EPIDEMIOLOGY
Support, Non-U.S. Gov't Toxoplasmosis/EPIDEMIOLOGY JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).