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1994-10-25
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Document 2106
DOCN M94A2106
TI The changing spectrum of AIDS index diseases in Canada.
DT 9412
AU Schechter MT; Sutherland D; Hogg RS; Strathdee SA; Le TN; O'Shaughnessy
MV; Montaner JS; BC Centre for Excellence in HIV/AIDS, Vancouver,
Canada.
SO Int Conf AIDS. 1994 Aug 7-12;10(1):38 (abstract no. 124C). Unique
Identifier : AIDSLINE ICA10/94370469
AB OBJECTIVE: To describe the changing spectrum of AIDS index diseases in
Canada from 1981 to 1991. METHODS: The present analysis was based on the
AIDS index diseases reported to the Bureau of HIV/AIDS Epidemiology as
of March 1993. Analysis was restricted to persons aged 15-64 years who
were diagnosed prior to December 31, 1991. The annual number of AIDS
cases were adjusted for reporting delay; disease-specific incidence
rates were calculated by standardizing rates to the 1991 Canadian
population. Linear regressions were performed to test the changes in
annual incidence rates for each index disease. Reported p-values are
two-sided. RESULTS: A total of 6,641 adult AIDS cases were examined:
6,304 (94.9%) males, 337 (5.1%) females. As seen in the figure, the
incidence of 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
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). Significant rate increases were
observed for esophageal candidiasis, cytomegalovirus diseases, wasting
syndrome, toxoplasmosis, and Mycobacterium avium complex disease.
Changes in incidence over this period were especially marked for
esophageal candidiasis where rates increased from 0.11 to 1.27 per
100,000 (p < 0.001), and for CMV where rates increased from 0.01 to 0.40
per 100,000 (p = 0.002). CONCLUSIONS: These findings highlight the
importance of developing specific strategies to deal with emerging
AIDS-associated diseases. Our data provide a cautionary note to
practicing clinicians with regard to the relative widening of the
spectrum of HIV index diseases. TABULAR DATA, SEE ABSTRACT VOLUME.
DE Acquired Immunodeficiency Syndrome/*EPIDEMIOLOGY Adolescence Adult
AIDS-Related Opportunistic Infections/EPIDEMIOLOGY Canada/EPIDEMIOLOGY
Female Human Incidence Male Middle Age Pneumonia, Pneumocystis
carinii/EPIDEMIOLOGY Regression Analysis Sarcoma,
Kaposi's/EPIDEMIOLOGY MEETING ABSTRACT
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).