HIV diagnoses in children and adolescents: the key issues within the region and different age groups Otilia Mardh, ECDC Friday 7 th October 2016 07/10/2016 Ageing with HIV Phase 2: New challenges and unmet needs of children and adolescents living and ageing with HIV/AIDS 1
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HIV diagnoses in children and adolescents: key issues in Europe and different age groups
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Ageing with HIV Phase 2: New challenges and unmet needs of children and adolescents living and ageing with HIV/AIDS
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HIV diagnoses in children and adolescents:the key issues within the region and different age groups
Otilia Mardh, ECDC
Friday 7th October 2016
07/10/2016
Ageing with HIV Phase 2: New challenges and unmet needs of children and adolescents living and ageing with HIV/AIDS
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Global data on HIV among children and adolescents “Turning the tide against AIDS will require more concentrated focus
on adolescents and young people”
In 2014,• 220,000 children (0-14 y/o)
newly infected with HIV; 86% SSA, 0.5% CEE/CIS;
• 2.0 million of adolescents (10-19 y/o) were living with HIV worldwide; 82% in sub-Saharan Africa
• 12% of new HIV infections were in adolescents
• 40% of new infections among 15-19 y/o occurred outside of SSA
07/10/2016
Source: UNAIDS 2014 HIV and AIDS estimates, July 2015.http://data.unicef.org/hiv-aids/adolescents-young-people.html#sthash.KiNdOThS.dpuf
Ageing with HIV Phase 2: New challenges and unmet needs of children and adolescents living and ageing with HIV/AIDS
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HIV diagnoses among children and adolescents (0-19 years), EU/EEA
07/10/2016
• 786 new HIV diagnoses in 2014
• 9 031 new HIV diagnoses between 2005-2014 1 460 (16%) 0-4 years 1 372 (15%) 5-14 years 6 199 (69%) 15-19 years
Source: The European Surveillance System, 30 EU/EEA reporting countries
Ageing with HIV Phase 2: New challenges and unmet needs of children and adolescents living and ageing with HIV/AIDS
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In EU/EEA, HIV diagnoses among children and adolescents (0-19 years)
07/10/2016
• 786 new HIV diagnoses in 2014
• 9031 new HIV diagnoses between 2005-2014 1460 (16%) 0-4 years 1372 (15%) 5-14 years 6199 (69%) 15-19 years
Source: The European Surveillance System, 30 EU/EEA reporting countries
Several questions to answer: • Main modes of transmission? • Trends? • Demographic characteristics? • Public health implications?
Ageing with HIV Phase 2: New challenges and unmet needs of children and adolescents living and ageing with HIV/AIDS
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Reported transmission modes for HIV diagnoses among children and adolescents (0-19 years), 2005-2014, EU/EEAN=9031
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N=1 460 N=1 372 N=6 199 0-4 years 5-14 years 15-19 years
Source: The European Surveillance System, 30 EU/EEA reporting countries
Ageing with HIV Phase 2: New challenges and unmet needs of children and adolescents living and ageing with HIV/AIDS
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Trends of HIV diagnoses among children and adolescents (0-19 years), by mode of transmission, 2005-2014, EU/EEA
07/10/2016
Source: The European Surveillance System, 30 EU/EEA reporting countries Note: Italy and Spain not included due to changes in surveillance systems
Ageing with HIV Phase 2: New challenges and unmet needs of children and adolescents living and ageing with HIV/AIDS
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HIV diagnoses among 15-19 years olds, by region of origin and transmission, EU/EEA,2005-2014
07/10/2016
Born in reporting country Foreign-born
Source: The European Surveillance System, 30 EU/EEA reporting countries
Injecting drug use
Heterosexual (boys and girls)
Nosocomial or Transfusion
Sex between men
Mother-to-child transmission
Undetermined
Note: Italy and Spain not included due to changes in surveillance systems
Ageing with HIV Phase 2: New challenges and unmet needs of children and adolescents living and ageing with HIV/AIDS
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Mother-to-child transmission of HIV in EU/EEA
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Analysis of 30-years of data on HIV diagnoses
Ageing with HIV Phase 2: New challenges and unmet needs of children and adolescents living and ageing with HIV/AIDS
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Numbers of HIV-MTCT cases reported by EU/EEA countries, by place of birth* and by year of diagnosis; 1984-2014 (N=6270)
07/10/2016
• All HIV-MTCT reports from EU/EEA countries retrieved from TESSY (up to 2014)
• *Assessment of place of birth was based on: country of birth, region of origin
Source: The European Surveillance System, 30 EU/EEA reporting countries
HIV-MTCT cases born in reporting EU/EEA countries by year of diagnosis and by calculated* year of birth
MTCT by year of diagnosis (N=3410)
• The year of birth (currently not reported in TESSy) was calculated by subtracting age from date of diagnosis year .
• For this analysis, the year of birth estimates the year of MTCT.
Ageing with HIV Phase 2: New challenges and unmet needs of children and adolescents living and ageing with HIV/AIDS07/10/2016
Source: The European Surveillance System, 30 EU/EEA reporting countries
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HIV-MTCT cases born in reporting EU/EEA countries by year of diagnosis and by calculated* year of birth
• The year of birth (currently not reported in TESSy) was calculated by subtracting age from date of diagnosis year .
• For this analysis, the year of birth estimates the year of MTCT.
Ageing with HIV Phase 2: New challenges and unmet needs of children and adolescents living and ageing with HIV/AIDS07/10/2016
Source: The European Surveillance System, 30 EU/EEA reporting countries
Age at diagnosis: median 1, IQR [0, 4]
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HIV-MTCT cases reported by five countries accounting for 2/3 of all reports, by year of birth/transmission
Ageing with HIV Phase 2: New challenges and unmet needs of children and adolescents living and ageing with HIV/AIDS07/10/2016
Source: The European Surveillance System, 30 EU/EEA reporting countries
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EU/EEA rate 2010-2014: 1.0N=274
HIV-MTCT cases per 100 000 live births in persons born in reporting EU/EEA countries, rates 2010-2014
Ageing with HIV Phase 2: New challenges and unmet needs of children and adolescents living and ageing with HIV/AIDS07/10/2016
• National HIV-MTCT rates per 100 000 live-births (vertical transmission rates) calculated by dividing the number of HIV-MTCT cases born in the reporting country by the number of live births (Eurostat) for the period 2010-2014
Source: The European Surveillance System, 30 EU/EEA reporting countries
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HIV-MTCT foreign-born cases diagnosed in EU/EEAby region of origin and year of diagnosis in the reporting country
07/10/2016
Source: The European Surveillance System, 30 EU/EEA reporting countries Ageing with HIV Phase 2: New challenges and unmet needs of
children and adolescents living and ageing with HIV/AIDS 14
Age at diagnosis in EU/EEA: median 6, IQR [2, 12]
Ageing with HIV Phase 2: New challenges and unmet needs of children and adolescents living and ageing with HIV/AIDS
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Key findings and public health implications
• <3% of new HIV diagnoses in 2014 among 0-19 years olds• HIV-MTCT in EU/EEA-born children is declining and is below
WHO elimination target (<50 per 100,000 LB)• Antenatal screening to be targeted at subpopulations at risk*
(ECDC Guidance Antenatal screening among vulnerable groups, in press)
• HIV diagnoses increasing among young MSM (European-born). Targeted prevention strategies, youth-friendly prevention and health-care services (ECDC Guidance HIV and STI prevention among men who have sex with men. 2015)
07/10/2016
*ECDC Technical report. Antenatal screening for HIV, hepatitis B, syphilis and rubella susceptibility in the EU/EEA . Stockholm: ECDC; 2016.
Ageing with HIV Phase 2: New challenges and unmet needs of children and adolescents living and ageing with HIV/AIDS
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Thank you!Acknowledgements • Anastasia Pharris, ECDC • EU/EEA HIV/AIDS surveillance network for providing data to TESSy