Suchergebnisse

Clinical surveillance was the only way to detect bovine spongiform encephalopathy (BSE) until July 2000 in France. From the 103 cases identified as such between 1991 and June 2000, we used a back‐calculation method to reconstruct the longitudinal trend of BSE infections. Between July 1987 and June 1997, an estimated 51,300 (CI =[24,300–84,700]) cattle were infected in France. The comprehensive surveillance of BSE with rapid tests, set up in France since 2001 at the abattoir and fallen plant, allowed study of the relative exposure of the successive birth cohorts with nonconditional logistic regression models adjusted for possible confounding variables. The results were in agreement with those of the back‐calculation model, estimating a decrease of the BSE exposure from the birth cohort July 1995–June 1996 that matched with the decrease of the infection after June 1996. In view of the long incubation period of BSE, it is not possible to precisely assess the impact of any control measure before several years. Modeling was therefore used to estimate prospectively the efficiency of the ban of meat and bone meal extended to all farm species in November 2000. Using parameters about age at infection and incubation time estimated earlier, we assessed the minimum time to first detection if infections still occurred. We have waited up to June 2007 to know if less than 100 infections occurred among French cattle during the 6 months following January 2001.

7‐11 November 2010, Tenth International Congress on Drug Therapy in HIV Infection, Glasgow, UK

7‐11 November 2010, Tenth International Congress on Drug Therapy in HIV Infection, Glasgow, UK

Purpose of the studyTo describe long‐term incidence trends and median age at diagnosis for the three AIDS‐defining cancers (ADC) in HIV‐1‐ infected (HIV1+) patients compared to general population. To study the risk of ADC in HIV1+patients with good immune status (CD4≥500/mm3 for at least 2 years).MethodsIncident ADC (Kaposi's sarcoma [KS], non‐Hodgkin's lymphomas [NHL] and cervix uteri cancer [CUC]) were retrieved in HIV1+adults followed in the French hospital database on HIV (FHDH) cohort between 1992 and 2009. Cancer incidence rates (IR) in general population were calculated using data from the French cancer registries (Francim network). IR among the HIV1+and the general population were standardized using the 5 years age and sex groups structure of the HIV1+population (1997–2009) and standardized incidence ratios (SIR) were estimated in HIV1+ patients vs. general population in 4 calendar periods (1992–1996, 1997–2000, 2001–2004, and 2005–2009). Median age at diagnosis was estimated after adjusting for the difference in age structure between HIV1+and general population.Summary of results5,935 incident ADC were diagnosed among 100,536 HIV1+ patients followed between 1992 and 2009. All ADC IRs were significantly reduced between pre‐ and post‐cART eras and continue to decline in the cART period (p<10−4). SIR are presented in the table.Median age at diagnosis was significantly younger among HIV1+ patients than the general population for KS (40.4 vs. 42.5; p<10−4), NHL (41.4 vs. 52.5; p<10−4) and CUC (39.3 vs. 42.5; p<10−4). For HIV1+ patients under treatment who maintained controlled viral load (<500 copies/µL) and CD4 ≥500/mm3 for at least 2 years, the risk for KS, NHL and CUC were respectively SIR=71.6 (28.7–147.5), 2.4 (0.9–4.8) and 1.6 (0.3–4.7) vs. general population.ConclusionsThe incidence rates of KS, NHL and CUC continued to decline through 2009 but the risk remained elevated as compared to general population in the most recent cART period. Despite the great reduction when compared to general population, the risk is still very high for KS in HIV1+patients who maintained CD4 ≥500/mm3 for at least 2 years. The risk was not significant for CUC and NHL.















Pre‐cART (1992–1996)
Early‐cART (1997–2000)
Intermediate‐cART (2001–2004)
Lte‐cART (2005–2009)



O/E
SIR (95% CI)
O/E
SIR (95% CI)
O/E
SIR (95% CI)
O/E
SIR (95% CI)




Kaposi's sarcoma
2177/0.9
2299.7 (2204.1–2398.4)
462/0.4
1080.1 (983.87–1183.3)
403/0.4
1130.1 (1022.5–1246.1)
354/0.4
817.7 (734.8–907.52)


Non– Hodgkins's lymphoma
1111/4.0
278.7 (262.5–295.6)
515/6.2
83.8 (76.7–91.4)
370/8.8
42.1 (37.9–46.6)
372/14.8
25.1 (22.6–27.8)


Cervix uteri
38/3.2
12.0 (8.5–16.5)
48/5.3
9.1 (6.7–12.1)
37/7.0
5.3 (3.7–7.3)
48/10.4
4.6 (3.4–6.1)





O/E: Observed cases / Expected cases.

BACKGROUND: UNAIDS has set a 90-90-90 target to curb the HIV epidemic by 2020, but methods used to assess whether countries have reached this target are not standardised, hindering comparisons. METHODS: Through a collaboration formed by the European Centre for Disease Prevention and Control (ECDC) with European HIV cohorts and surveillance agencies, we constructed a standardised, four-stage continuum of HIV care for 11 European Union (EU) countries for 2013. Stages were defined as: 1) number of people living with HIV (PLHIV) in the country by end of 2013; 2) proportion of stage 1 ever diagnosed; 3) proportion of stage 2 ever initiated ART; and 4) proportion of stage 3 who became virally-suppressed (≤200 copies/mL). Case surveillance data were used primarily to derive stages 1 (using back-calculation models) and 2, and cohort data for stages 3 and 4. RESULTS: In 2013, 674,500 people in the 11 countries were estimated to be living with HIV, ranging from 5,500 to 153,400 in each country. Overall HIV prevalence was 0.22% (range 0.09%-0.36%). Overall proportions, of each previous stage, were 84% diagnosed, 84% on ART, and 85% virally-suppressed (60% of PLHIV). Two countries achieved ≥90% for all stages, and over half had reached ≥90% for at least one stage. CONCLUSIONS: EU countries are nearing the 90-90-90 target. Reducing the proportion undiagnosed remains the greatest barrier to achieving this target, suggesting further efforts are needed to improve HIV testing rates. Standardising methods to derive comparable continuums of care remains a challenge.