Epidemiology Sept2011 PDF

UPDATE OF HIV
EPIDEMIOLOGY IN ROMANIA
OVERVIEW OF HIV EPIDEMIC IN
ROMANIA- EXPERIENCE WITH
LONG TERM SURVIVORS -
TEENAGERS AN YOUNG ADULTS
DR.MARIANA MRDRESCU
Coordinator of Compartment for

Monitoring and Evaluation of HIV/AIDS
Data in Romania - INBI Prof.Dr.M.Bal
At a global level, HIV infection is constantly expanding, with an
epidemiologic profile set by local and regional factors.
According to UNAIDS estimates, at the end of 2009 there were

over 33 million PLWHA worldwide, compared to 26 million
PLWHA reported in 1999 (a 27% increase in this number).
At the end of 2009, the estimated number of HIV positive children

was calculated at the value of 2,5 million, while the proportion of
women living with HIV/AIDS apparently remained stable, namely
15,9 million.
Unlike the infections in other Eastern and Central European

Countries,HIV/AIDS infection in Romania is a different
phenomenon.
The specificity of the epidemic consists of a high rate of HIV
incidence at children, infected at the end of the 1980s, the maximum
number of these patients having been recorded in the beginning of
the 1990s.
During the same period the rate of HIV incidence among the adult
population was low, with a significant increase afterwards, by
heterosexual contact.
According to the data provided by Compartment for Monitoring and

Evaluation of HIV/AIDS Data in Romania, in National Institute of
Infectious Diseases Prof. Dr. Matei Bals, at 30 September 2011
17.212 cumulative cases of HIV/AIDS cases were recorded, with a
figure of 10.765 people living with HIV/AIDS.
Recent information released by UNAIDS (December 2009) ranks the

number of PLWHA in Romania between 12.000-16.000 persons.
The difference between the number of the diagnosed patients and
the estimates is relatively small next to other Central and Eastern
European countries.
The rate of HIV prevalence at adults was somewhere below 0.1% ,

at 31 December, 2010.
Currently, Romania has a large number of survivors, integrated in

the 19-24 age group, who belong to the 1987-1990 cohort (>6000)
and a large number of PLWHA who receive specific ARV therapy in
relation to the total number of infected persons (>7000).
Due to an optimal therapy administration, the mean period of

survival has increased from 3 month is 1990-2000 to 84 months
today.
The current tendencies of the HIV/AIDS infection in
Romania are:
The same main way of transmission for adults - unsafe heterosexual

contact - 63% of the new cases.
A slight decrease in the vertical transmission (mother to child)-

2,5% in 2011 vs. 4,8% in 2010.
A relevant increase for the IDU group (15% in 2011 vs. 3% in

2010).
A doubled number of infections among the MSM group compared

with 2009, namely from 8% to 16% in 2011.
An overall increase of PLWHA who require specific medical

services and ARV therapy.
Due to the epidemiologic particularity,
namely the long term survivals, who have
experienced multiple therapeutic
schemes, the problem of ART resistance
is major, with many implications in the
design of potent therapeutic schemes.
The activity related to HIV/AIDS in
Romania is coordinated by Ministry of
Health and National Health Insurance
House, which provide both the activity of
prevention and the specific ART
treatment.
The order approving the technical norms for national health
programs, during 2011-2012 manages (1591/1110, December 2010):
The program for surveillance and control of the HIV infection through
National Institute of Public Health and National Institute of Infectious
Diseases Prof. Dr. Matei Bals, the nine Regional HIV/AIDS Centers
and Public Health Counties.
The program for surveillance and control for the abovementioned

period targets:
Maintaining a low rate of incidence at the adult population;

The reduction of mother to child transmission.
The program addresses to the general population and to the

vulnerable groups (see HIV TESTS* BY RISK GROUPS IN 2011
slide).
The treatment program is coordinated by
National Institute of Infectious Diseases
Prof. Dr. Matei Bals, the nine Regional
HIV/AIDS Centers and sustained by
National Health Insurance House.
The HIV/AIDS Strategy for 2011-2015 is
in process of approval.
Guiding principles of
National HIV/AIDS Strategy
1. HIV/AIDS represents more than a public health priority. It is a
complex problem, which affects all the layers of a society.
2. The strategy will emphasize the prevention methods against

HIV transmission and the reduction of the social impact. The
assigned resources must take in consideration vulnerable
groups and individuals at risk as well as the affected
communities.
3. Multisectoral and interdisciplinary involvement at a national level

is essential for an adequate answer to the HIV/AIDS problem.
4. Vulnerable persons and groups at risk must have the necessary

knowledge and access to adequate services in view of
preventing the infection with HIV virus.
5. HIV/AIDS programs/interventions, especially those
addressing to vulnerable and at high risk of infection
groups must be adapted to age, sex, culture and
behavious differences.
6. All PLWHA or diagnosed with AIDS, as well as
vulnerable groups have equal and permanent to
tratement, medical care and social services, in
accordance with according the standards stipulated
by the legislation.
7. The rights of PLWHA and of vulnerable groups are
granted by the national legislation and by the
International Ttreaties, which Romania signed.
8. Law establishes individual responsibilities of PLWHA.
9. Universal precautions will be applied in view of preventing all
possibilities of HIV transmission, within the sanitary and the
social assistance systems.
10. HIV testing is voluntary, and/or anonymous, confidential,

accompanied by pre- and post - test counselling, in both private
and state sectors.
11. The form of policies and and socio-economic programs

development must also be based on HIV/AIDS phenomenon.
12. The present strategy serves as a main orientation document for

the elaboration of programs and national, local projects of
intervention within the HIV/AIDS field.
MINISTRY OF HEALTH
NATIONAL INSTITUTE OF INFECTIOUS DISEASES PROF.DR.MATEI BAL
Compartment for Monitoring and Evaluation of HIV/AIDS Infection in Romania
GENERAL DATA AT 30 SEPTEMBER 2011
TOTAL HIV/AIDS CASES (CUMULATIVE 1985-2011) OUT 17.212

OF WHICH:
HIV/AIDS CASES at children (0-14 years at diagnosis date) 9.866
HIV/AIDS CASES at adults (> 14 years at diagnosis date) 7.346
Total no. of AIDS deaths 5.850
Out of records HIV/AIDS children + adults 597
NUMBER OF PLWHA (people living with HIV/AIDS) 10. 765
TOTAL AIDS CASES (CUMULATIVE 1985-2011) 12.369
AIDS Cases at children (0-14 years at diagnosis date) 7.941
AIDS Cases at adults (> 14 years at diagnosis date) 4.428
TOTAL HIV CASES (CUMULATIVE 1992-2011) 4.843
HIV Cases at children (0-14 years at diagnosis date) 1. 925

HIV Cases at adults (> 14 years at diagnosis date) 2.918
NEW HIV/AIDS CASES, diagnosed during 01.01 30.09.2011 405
NEW HIV NOTIFIED CASES 226
NEW AIDS NOTIFIED CASES 179
NUMBER OF DEATHS IN 2011 (01.01-30.09.2011) 117
S ource: Compartment for Monitoring and Evaluation of HIV/AIDS Infection in Romania INBI Prof.Dr.M.Bal
MINISTRY OF HEALTH
Compartment for Monitoring and Evaluation of HIV/AIDS Infection in Romania
GENERAL DATA AT 30 SEPTEMBER 2011
Patients in active records HIV+AIDS 8.916

Children (0-14 years*) 234
Adults(> 14 years*) 8. 682
Patients with ARV treatment 7.352
Children (0-14 years*) 192
Adults (> 14 years*) 7.160
Persons who received ARV prophylaxis 384
Persons who interrupted the ART treatment 354
voluntarily
*current age
TENDENCES OF THE TRANSMISSION WAY
IN ROMANIA 2007-2011
30
TRANSMISSION
2007 2008 2009 2010 September
WAY
2011
Vertical 9 (2,44%) 12 (2,7%) 22 (5%) 21 (4,8%) 10 (2,5%)
MSM 14 (3,8%) 33 (7,5%) 34 (8%) 46 (10,5) 63 (15,5%)
IDU 3 (0,8%) 3 (0,7%) 5 (1,1%) 12 (2,7%) 62 (15,3%)
Heterosexual 278 (75%) 302 (69%) 324 (75%) 329 (74,7%) 254 (62,7%)
Undetermined 64 (17%) 86 (20%) 43 (10%) 32 (7,3%) 16 (4%)
Total 368 436 428 440 405
S ursa: Compartimentul pentru Monitorizarea i Evaluarea infeciei HIV/S IDA n Romnia INBI Prof.Dr.M.Bal
TENDENCES OF THE TRANSMISSION
WAY IN ROMANIA 2007-2009
2007 2008
2% 4% 3% 8%
17% 20%
Vertical Vertical
1% 1%
MSM MSM
Heterosexual Heterosexual
IDU IDU
Undetermined Undetermined
76% 68%
2009
10% 5% 8%
1%
Vertical
MSM
Heterose xual
IDU
Undetrem ined
76%
Source: Compartment forMonitoring and Ev aluation of HIV/AIDS Infection in Romania INBI Prof.Dr.M.Bal
TENDENCES OF THE
TRANSMISSION WAY IN ROMANIA
2010-2011
2010 30 September 2011

3% 7% 5% 4% 2%
10% 15% 16%
Vertical Vertical
MSM MSM
Heterosexual Heterosexual
IDU IDU
Undetermined Undetermined
75% 63%
Source: Compartment forMonitoring and Ev aluation of HIV/AIDS Infection in Romania INBI Prof.Dr.M.Bal
HIV/AIDS incidence at adults and children, between 1985 2010
(per 100.000)
5,65
5,43
5,19
5 4,98
4,83
4,13
4 3,91
3
2,78
2,27
2
1,76
1,5 1,43
1,3 1,25 1,24
1,17 1,22 1,12
1,09 1,06
1
0,84 0,83
0,7
0,59 0,52 0,59 0,54
0,39 0,45 0,43
0,29 0,27 0,21 0,27
0,2
0 0,08 0,08 0,09
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
Children Adults
Children 2010: 0,43/100.000

Adults 2010: 1,24/100.000
Source: Compartment for Monitoring and Evaluation of HIV/A IDS Infection in Romania INBI Prof.Dr.M.Bal
AGE PYRAMID TOTAL 31 DECEMBER 2010
AGE AT DISCOVERY/NOTIFICATION DATE CURRENT AGE
TOTAL 1985-2010
GENDER
sex SEX
GENDER
F M F M
peste 70 ani peste 70 ani peste 65 ani peste 65 ani

65-69 ani 65-69 ani
60-64 ani 60-64 ani
60-64 ani 60-64 ani
55-59 ani 55-59 ani
55-59 ani 55-59 ani
50-54 ani 50-54 ani
50-54 ani 50-54 ani
45-49 ani 45-49 ani 45-49 ani 45-49 ani
grupa de varsta
grupa de varsta
varsta
de varsta
40-44 ani 40-44 ani 40-44 ani 40-44 ani
35-39 ani 35-39 ani
A ge group
35-39 ani 35-39 ani
group
A ge group
A ge group
30-34 ani 30-34 ani
A gede
30-34 ani 30-34 ani

25-29 ani 25-29 ani
grupa
grupa
21-24 ani 21-24 ani 25-29 ani 25-29 ani
19-20 ani 19-20 ani 20-24 ani 20-24 ani
17-18 ani 17-18 ani 15-19 ani 15-19 ani

15-16 ani 15-16 ani
10-14 ani 10-14 ani
10-14 ani 10-14 ani
5-9 ani 5-9 ani
5-9 ani 5-9 ani
1-4 ani 1-4 ani
1-4 ani 1-4 ani
0-1 an 0-1 an 0-11 luni 0-11 luni
2,500 2,000 1,500 1,000 500 0 500 1,000 1,500 2,000 2,500 4,000 3,000 2,000 1,000 0 1,000 2,000 3,000 4,000
nr cazuri Count
Count
AGE PYRAMID (deceased patients vs.PLWHA) BY CURRENT AGE
DECEASED PLWHA
Current age
Current age
No. cases No. of cases

Analysis of the survival rate, Kaplan-Meier type
50% of deaths had a mean
period of survival (POS)< 50
months;
POS of 50 months;
POS 100 months;
Limits: periods without
treatment, ARV schemes,
duration of treatment are
excluded
Mean POS= 37.4 months

(C.I.95% 35,1-38,1)
Mean POS for men= 36,6

months (C.I.95% 35,1-38,1)
Mean POS for women= 38,6

months (C.I.95% 36,7-40,5)
months
Source: Compartment for Monitoring and Ev aluation of HIV/AIDS Infection in Romania INBI Prof.Dr.M.Bal
PATIENTS WITH ART AND IN ACTIVE RECORDS BY
REGIONAL CENTRES 30 SEPTEMBER 2011
3000
2734
2492
2500
2000 1852
1500
1345
1154 1166
1000 914
744 760
662
518 460
500 359 301
245 204
189 170
0
INBI M.BAL S V.BABES BRASOV CLUJ CONSTANTA CRAIOVA IASI T G.MURES TIMISOARA
ACT IVE RECORDS ART
ARV SCHEMES AT 30 SEPTEMBER 2011
1% 1% 2% 10%
2%
2%
18% 64%
2 INRT + 1 IP/r 2 INRT + 1 INNRT

1 INRT + 1 INNRT + 1 IP/r 3 INRT + 1 IP/r
3 INRT 2 INRT + 1 INNRT + 1 IP/r
2 INRT + 1 IP/r + 1 II OTHER
ADULTS ( 15 YEARS):
NUMBER OF ARV SCHEMES, PRIOR TO THE CURRENT ONE
NO. OF PATIENTS
0% 0%
1% 00%
% 0% 0 sc hemes
2% 0%
0% 1 schemes
11% 3% 2 sc hemes
6% 20 %
3 sc hemes
4 sc hemes
5 sc hemes
6 sc hemes
7 sc hems
8 sc hemes
9 sc hemes
10 schemes
11 sc hemes
2 2% 12 schemes
15 % 13 schemes
14 schemes
17 schemes
2 0%
CHILDREN (0-14 YEARS):
NUMBER OF ARV SCHEMES, PRIOR TO THE CURRENT ONE
4% 2% 1% 1%
?
10% 29%
0 schemes
1 schemes
2 schemes
3 schemes
23%
4 schemes
30%
5 schemes
8 schemes
AVERAGE SURVIVAL PERIOD (IN MONTHS) OF AIDS PATIENTS ,
BETWEEN 1990 - 2010
90
80
70
60
50
40
30
20
10
0
90 91 92 93 94 95 96 97 98 99 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
No. of months 3 9 16 18 28 26 31 34 36 42 44 42 56 60 55 57 61 77 82 83 82
Initiation of ART bi therapy Initiation of ART tri therapy
HIV TESTS* BY RISK GROUPS IN 2011
Risk group Negative tests Positive tests TOTAL %POZITIVE
STI 2960 23 2983 0,77

TBC 11201 168 11369 1,48
MATERNITY 411 27 438 6,16
PREGNANT WOMEN 91068 68 91136 0,07

MEDICAL STAFF 6748 6748 0,00
HEMODIALYSIS 2598 2598 0,00
TRANSFUSION RECEPIENT 230 230 0,00
PRENUPTIAL CHECK-UP 4989 5 4994 0,10
IV DRUG USERS 42 3 45 6,67

INMATES 304 304 0,00
MSM 50 7 57 12,28
SEX WORKERS 66 4 70 5,71
HIV CONTACTS 693 61 754 8,09

SAILORS 5625 2 5627 0,04
DRIVERS 15 15 0,00
WORK ABROAD > 6 MONTHS 359 1 360 0,28
STAY ABROAD > 6 MONTHS 115 1 116 0,86

REQUEST 86472 918 87390 1,05
OCCASIONAL 15228 780 16008 4,87
TOTAL 229174 2068 231242 0,89
* The data is received from County Public Health Authorities
POSITIVE TESTS BY RISK
GROUPS IN 2011 (%)*
0% 0% 0% 0% 0%
0% 1% PRENUPTIAL CHECK-UP
0% IDU
1% 3%
3% MSM
8% SEX WORKERS
39% SAILORS
STAY ABROAD > 6 MONT HS
WORK ABROAD > 6 MONT HS
STI
MATE RNITY
HIV CONTACTS
PREGNANT WOMEN
TBC
45%
REQUEST
OCCA SIONAL
*From 2527 positive tests

HIV TESTINGS IN STI PATIENTS
16000 70
14000 60
12000
50
P ositi ve tests
10000
40
T ota l tes ts
8000
30
6000
20
4000
10
2000
0 0
YEAR 91 92 93 94 95 96 97 98 99 '00 '01 '02 '03 '04 '05 '06 '07 '08 '09 ' 10
TOTAL NO. OF TESTS 4106 3779 4741 3116 3725 3849 4317 4873 5200 10640 8216 14414 13283 14856 12139 6149 5632 9343 5353 4019
Positive testings 8 6 6 4 23 19 24 21 19 39 46 60 42 43 29 21 35 27 27 27
TOTAL NO. OF TESTS Positive testing s
Source: Compartment of Monitoring and Evaluation of HIV/AIDS data in Romania INBI Prof.Dr.M.Bal
HIV TESTINGS IN TBC PATIENTS
18000 140
16000
120
14000
P o s itiv e te s ts
100
T o ta l te s ts
12000
10000 80
8000 60
6000
40
4000
20
2000
0 0
YEAR '90 '91 '92 ' 93 '94 '95 '96 '97 ' 98 ' 99 '00 '01 '02 '03 ' 04 '05 '06 '07 '08 ' 09 '10
Total no. of testings 1300 842 821 1662 1067 597 3451 3195 1527 1822 10719 10578 11946 11025 7440 10392 10821 11832 15799 14032 13451
Postive tests 15 18 8 14 15 23 27 25 19 39 54 37 55 55 47 75 84 94 113 101 128
HIV TESTINGS IN BLOOD DONORS
60000 0 60
50000 0 50
40000 0 40
Positive tests
Total tests
30000 0 30
20000 0 20
10000 0 10
0 0
1990 1991 1992 199 3 199 4 199 5 199 6 19 97 1 998 1 999 2 000 2 001 2002 2003 2004 2005 2006 2007 2008 2009 2010
YEAR
Total no. of te stings 3E+0 5 5E+05 4E+05 5 E+05 5 E+05 6 E+05 4 E+05 5E+05 5E+05 4E+05 3E+05 4E+05 4E+05 3E+05 4E+0 5 4E+0 5 3E+0 5 3E+05 4E+05 4 E+05 4E+05
Po stiv e test s 20 12 19 33 21 14 18 34 29 21 20 35 15 29 28 17 19 25 38 36 50
Tot al no. o f t est ing s Pos tiv e t est s
HIV TESTINGS IN PREGNANT WOMEN
120000 140
100000 120
P o si tiv e te s ts
100
T o ta l te s ts
80000
80
60000
60
40000
40
20000 20
0 0
YEAR ' 93 ' 94 ' 95 ' 96 '97 '98 '99 '00 '01 '02 '03 '04 '05 '06 '07 ' 08 ' 09 ' 10
Total no. of testings 890 711 13166 5823 17367 4580 7746 27367 26064 43024 51978 72802 61127 78020 81439 100061 99730 111037
Postive tests 0 0 3 0 3 1 2 11 15 33 27 40 62 81 86 107 83 117
TESTINGS IN HIV CONTACTS
1200 100
90
1000
80
70
T o ta l te s ts
800
60
600 50
40
400
30
20
200
10
0 0
YEAR ' 01 ' 02 '03 '04 '05 '06 '07 '08 '09 '10
Total no. of testings 769 655 977 563 383 569 704 966 909 976
Positive testings 7 19 36 23 39 17 35 92 70 78
REQUESTED HIV TESTINGS
140000 2500
120000
2000
100000
T o ta l te s ts
1500
80000
60000 1000
40000
500
20000
0 0
YEAR 2003 2004 2005 2006 2007 2008 2009 2010
Total no. of testings 78915 101392 89537 81099 99524 107998 118981 117345
Positive tests 1349 1926 884 945 1098 838 893 918
HIV TESTINGS* AT PREGNANT WOMEN BY
AGE GROUPS IN 2011
2% 5% 0,24% 9%
8%
26%
21%
29%
12-14 years 15-19 years 20-24 years 25-29 years

30-34 years 35-39 years > 40 years Unknown age
TB global incidence in Romania
1985-2009
160
142,2
140 134,1 135,6
134,6
123,7
119,6 121,9 123,6
120 114,5 116,2
102,6 107 106,8 115,4
114,3 113,5 106,4
105,5
94,2 106,5 103,3 99,9
100 89,4 102,1 103,8 93,9
87,8 87,1
95 98,7 97,8
79,6 83,2
80 87,4
70 66,8 82,5
63,4 73,5
58,2 61,3
60 55,8 56,4
64,6 61,6
58,3
50,7 51,3 53,2 56,2
40
20,3 19,4 20,3 20,3 19,6 18,6 18,4

20 15,8 17,2 18,7 16,7
12,4
5,1 5,2 6,9 7,6 8,3 9
5,1 5,1 5 5,1 5,4 6,1 6,8
0
1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
New cases & Relapses New cases Relapses
Source: National Institute of Pneumoftiziology Marius Nasta, Bucharest

Number of TB new cases and relapses,
1985-2009
35000
30984
30044 29470
30000
27756 29163
26847 26722
25765
24189 24640
25000 24189 26567
23271 25847 25245 22921
21422 24776 21457
23897
20349 23304
22976 22348 22679
22317
20000 21538
18097 22157 20396
16256 19871
15482 18773 18914
14676 18717
14137 17866
15000 12860 16719
12677 13361
14997
14275
13494
12960
10000 11519 12222
11692
4387 4374 4007 3962 3591

4197 4417 4225 4244
5000 3543 3859
2789
1158 1177 1182 1259 1207 1378 1576 1551 1733 1872 2032
1168 1139
0
1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
N ew cases&Relapses New cases Relap ses
Source: National Institute of Pneumoftiziology Marius Nasta, Bucharest

HIV-TB association
Current situation :
- In 2009 142 cases of HIV-TB co-infection were
registered, out of which 78 at the new AIDS
cases (2 children and 76 adults).
- In 2010 178 cases of HIV-TB co-infection were

registered, out of which 66 at the new AIDS
cases (1 child and 65 adults).
AIDS INDICATIVE DISEASES IN 2010
Recurrent sepsis
Burkitt l imphoma
Unspecified lymphoma
Extrapul monary tuberculosi s
Pul monary tuberculosis
Progressive mul tifocal l eukoencephalopathy
Herpes Simplex Vi rus Infection
Cryptococcosis
CMV disease
Kaposi' s Sarcoma
Toxoplasmosis
Recurrent pneumonia
Encephal opathy HIV related
Pneumocysti s pneumoni a
Wasti ng syndrome
Pulmonary candidiasis: bronchi/trachea/lung
Oesophageal candidiasis
0 20 40 60 80 100 120 140 160 180
AIDS INDICATIVE DISEASES IN 2011
Cryptosporidiosis
Recurrent sepsis
Burkitt l imphoma
Unspecified lymphoma
Extrapul monary tuberculosi s
Pul monary tuberculosis
Progressive mul tifocal l eukoencephalopathy
Herpes Simplex Vi rus Infection
Cryptococcosis
CMV disease
Kaposi' s Sarcoma
Toxoplasmosis
Recurrent pneumonia
Encephal opathy HIV related
Pneumocysti s pneumoni a
Wasti ng syndrome
Pulmonary candidiasis: bronchi/trachea/lung
Oesophageal candidiasis
0 20 40 60 80 100 120 140
The immunologic and virologic data
represent the joint effort of laboratories in
the nine Regional Centers in
collaboration with Compartment for
Monitoring and Evaluation of HIV/AIDS
data in Romania, in National Infectious
Diseases InstituteBucharest.
Infectious Diseases Hospital
Regional Centers County Public Health

University Clinics
National Institute of Infectious Diseases

Prof. Dr. Matei Bals
M.O.H. Naional Institute of ECDC WHO- Copenhagen

Statistics Stockholm
The data is collected from the HIV/AIDS
confirmation charts, sent by the
nine Regional Centers for Evaluation and
Monitoring of HIV/AIDS Data and further
processed and elaborated by Compartment
for Monitoring and Evaluation of HIV/AIDS
data in Romania, in National Infectious
Diseases InstituteBucharest.
Compartment for Monitoring and Evaluation of HIV/AIDS Infection in
Romania
Manager: Prof Adrian Streinu-Cercel

Head of Infectious Diseases Dep.
Carol Davila Medicine and Pharmacy Univ.
President of Infectious Diseases and AIDS
Commission
Coordinator: Dr. Mariana Mrdrescu

Coordinator of Adults Program: Conf.Dr.Elisabeta Otilia Benea
Coordinator of Children Program: Dr.Sorin Petrea
Statistical data operators :
PC Operators: As.med. Marieta Iancu

Daniela Vielaru
Sanda Vintil
Collaborators: Dr. Ionel Iosif- ISP Bucuresti

Romanian HIV/AIDS Center

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UPDATE OF HIV

Coordinator of Compartment for

According to UNAIDS estimates, at the end of 2009 there were

At the end of 2009, the estimated number of HIV positive children

Unlike the infections in other Eastern and Central European

According to the data provided by Compartment for Monitoring and

Recent information released by UNAIDS (December 2009) ranks the

The rate of HIV prevalence at adults was somewhere below 0.1% ,

Currently, Romania has a large number of survivors, integrated in

Due to an optimal therapy administration, the mean period of

The same main way of transmission for adults - unsafe heterosexual

A slight decrease in the vertical transmission (mother to child)-

A relevant increase for the IDU group (15% in 2011 vs. 3% in

A doubled number of infections among the MSM group compared

An overall increase of PLWHA who require specific medical

The program for surveillance and control for the abovementioned

Maintaining a low rate of incidence at the adult population;

The program addresses to the general population and to the

2. The strategy will emphasize the prevention methods against

3. Multisectoral and interdisciplinary involvement at a national level

4. Vulnerable persons and groups at risk must have the necessary

10. HIV testing is voluntary, and/or anonymous, confidential,

11. The form of policies and and socio-economic programs

12. The present strategy serves as a main orientation document for

TOTAL HIV/AIDS CASES (CUMULATIVE 1985-2011) OUT 17.212

HIV/AIDS CASES at adults (> 14 years at diagnosis date) 7.346

Total no. of AIDS deaths 5.850

Out of records HIV/AIDS children + adults 597

NUMBER OF PLWHA (people living with HIV/AIDS) 10. 765

TOTAL AIDS CASES (CUMULATIVE 1985-2011) 12.369

AIDS Cases at children (0-14 years at diagnosis date) 7.941

AIDS Cases at adults (> 14 years at diagnosis date) 4.428

TOTAL HIV CASES (CUMULATIVE 1992-2011) 4.843

HIV Cases at children (0-14 years at diagnosis date) 1. 925

NEW HIV NOTIFIED CASES 226

NEW AIDS NOTIFIED CASES 179

NUMBER OF DEATHS IN 2011 (01.01-30.09.2011) 117

Patients in active records HIV+AIDS 8.916

2010 30 September 2011

Children 2010: 0,43/100.000

peste 70 ani peste 70 ani peste 65 ani peste 65 ani

30-34 ani 30-34 ani

19-20 ani 19-20 ani 20-24 ani 20-24 ani

17-18 ani 17-18 ani 15-19 ani 15-19 ani

No. cases No. of cases

Mean POS= 37.4 months

Mean POS for men= 36,6

Mean POS for women= 38,6

ACT IVE RECORDS ART

2 INRT + 1 IP/r 2 INRT + 1 INNRT

Initiation of ART bi therapy Initiation of ART tri therapy

Risk group Negative tests Positive tests TOTAL %POZITIVE

STI 2960 23 2983 0,77

PREGNANT WOMEN 91068 68 91136 0,07

PRENUPTIAL CHECK-UP 4989 5 4994 0,10

IV DRUG USERS 42 3 45 6,67

SEX WORKERS 66 4 70 5,71

HIV CONTACTS 693 61 754 8,09

STAY ABROAD > 6 MONTHS 115 1 116 0,86

STAY ABROAD > 6 MONT HS

WORK ABROAD > 6 MONT HS

*From 2527 positive tests

TOTAL NO. OF TESTS Positive testing s