Suchergebnisse

The latest WHO data regarding HIV/AIDS infection have revealed the real dimension of this epidemic. In Romania, in 2011 out of 619 new detected cases, 19 represented children between 0–14 years. Vertical transmission was recorded for 16 (2.6%) of these cases. Within this epidemiological context, mother to child transmission continues to represent a top theme, which determined us to continue with the observations initiated in 2000 on this phenomenon.Purpose of the studyThe follow up of the evolution of a certain number of perinatally exposed children to HIV infection throughout 11 years, based on several risk factors: time of birth, time of the mother's and child's diagnosis; type of birth; type of nourishment for the newborn.MethodsDuring 01.01.2000–31.12.2011, 435 children from all around the country were included in the study and assessed at I.N.B.I "Prof. Dr. M. Bals" in Bucharest, with ages between 0–18 months. They were clinically and biologically evaluated until the age of 18 months. Relevant data on the children were recorded: gender, age, time of diagnosis, ART prophylaxis (YES or NO), type of birth and nourishment, CD4 count, VL at the initial time and at the end of the surveillance period. For mothers we focused on: age, environment, level of education, occupation, time of HIV diagnosis, treatment/prophylaxis, type of birth, CD4 and VL at birth (data obtained from medical records or anamnesis).ResultsOut of the surveyed 435 children, 16% were considered infected with HIV. This rate decreased in stages, from 45% in 2005 to 17% in 2010. The main transmission causes were late HIV diagnosis in the mother, lack of prophylaxis/treatment for mothers, natural birth, breastfeeding, lack of prophylaxis in children or tardiness in initiating it.ConclusionsThe rate of HIV transmission is still very high. The elimination of this infection route is globally considered a realistic objective of public health policies. In this sense, the collaboration and active involvement of specialists from various medical and social domains is a necessity.

Human immunodeficiency virus type 1 (HIV-1) was discovered in the early 1980s when the virus had already established a pandemic. For at least three decades the epidemic in the Western World has been dominated by subtype B infections, as part of a sub-epidemic that traveled from Africa through Haiti to United States. However, the pattern of the subsequent spread still remains poorly understood. Here we analyze a large dataset of globally representative HIV-1 subtype B strains to map their spread around the world over the last 50 years and describe significant spread patterns. We show that subtype B travelled from North America to Western Europe in different occasions, while Central/Eastern Europe remained isolated for the most part of the early epidemic. Looking with more detail in European countries we see that the United Kingdom, France and Switzerland exchanged viral isolates with non-European countries than with European ones. The observed pattern is likely to mirror geopolitical landmarks in the post-World War II era, namely the rise and the fall of the Iron Curtain and the European colonialism. In conclusion, HIV-1 spread through specific migration routes which are consistent with geopolitical factors that affected human activities during the last 50 years, such as migration, tourism and trade. Our findings support the argument that epidemic control policies should be global and incorporate political and socioeconomic factors.

Human immunodeficiency virus type 1 (HIV-1) was discovered in the early 1980s when the virus had already established a pandemic. For at least three decades the epidemic in the Western World has been dominated by subtype B infections, as part of a sub-epidemic that traveled from Africa through Haiti to United States. However, the pattern of the subsequent spread still remains poorly understood. Here we analyze a large dataset of globally representative HIV-1 subtype B strains to map their spread around the world over the last 50 years and describe significant spread patterns. We show that subtype B travelled from North America to Western Europe in different occasions, while Central/Eastern Europe remained isolated for the most part of the early epidemic. Looking with more detail in European countries we see that the United Kingdom, France and Switzerland exchanged viral isolates with non-European countries than with European ones. The observed pattern is likely to mirror geopolitical landmarks in the post-World War II era, namely the rise and the fall of the Iron Curtain and the European colonialism. In conclusion, HIV-1 spread through specific migration routes which are consistent with geopolitical factors that affected human activities during the last 50 years, such as migration, tourism and trade. Our findings support the argument that epidemic control policies should be global and incorporate political and socioeconomic factors.