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1994-10-25
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Document 2351
DOCN M94A2351
TI Combined surveillance of advanced HIV disease. Lazio AIDS Coll Group.
DT 9412
AU Abeni DD; Perucci CA; Ancona C; Brancato G; Peano RM; Sangalli M;
Epidemiology Unit, Lazio Region Health Authority, Roma, Italia.
SO Int Conf AIDS. 1994 Aug 7-12;10(1):324 (abstract no. PC0227). Unique
Identifier : AIDSLINE ICA10/94370224
AB OBJECTIVE: To provide a model of independent surveillance of severe
immunosuppression (SI) and AIDS. METHODS: Since May 1992, a
laboratory-based surveillance system (SS) on SI [< 200 CD4+/microL] is
active in the Lazio Region (approx. 5,000,000 residents), independently
from the AIDS registry [European definition, 1993]. Record linkage
between the two SSs yields surveillance according to the CDC 1993 AIDS
definition. In the study period (May 92-Oct 93), subjects were
classified according to the first SS they were reported to. Subjects
reported in the same semester to both SSs were classified as AIDS[Eur].
RESULTS: A total of 1768 subjects (AIDS-CDC93) was reported to the two
SSs: 732 AIDS[Eur] and 1036 SI cases. The overall AIDS-CDC93/AIDS[Eur]
ratio was 2.4, ranging from 2.3 to 2.6 in the 3 semesters. SI subjects
were more likely to be females (26.5% vs 22.8%) and < 35 yrs old (64.9%
vs 58.4%), and less likely to have < 100 CD4+/microL (39.4% vs 63.2%)
than AIDS[Eur] subjects. Only 67/1768 (3.8%) subjects had > 200
CD4+/microL. CONCLUSIONS: We demonstrate the feasibility of combined
surveillance of SI and AIDS: with very limited additional resources we
obtain a much more complete picture of the extent of advanced HIV
disease, essential for assessing real health care needs and planning
resource allocation. In our model, subjects with SI (including
asymptomatics) are granted access to benefits and entitlement programs
without being labelled as having AIDS. Furthermore, no information is
lost on the first clinical manifestation of AIDS, ensuring comparability
with previous surveillance. We propose that our model be adopted in the
EEC and in all Countries where CD4+ counts are widely available.
DE Acquired Immunodeficiency Syndrome/*EPIDEMIOLOGY/IMMUNOLOGY Adult
Cross-Sectional Studies Female Human Incidence Italy/EPIDEMIOLOGY
*Leukocyte Count Male *Population Surveillance Registries/STATISTICS
& NUMER DATA T-Lymphocytopenia, Idiopathic CD4-Positive/*EPIDEMIOLOGY/
IMMUNOLOGY T4 Lymphocytes/*IMMUNOLOGY MEETING ABSTRACT
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).