How many people are living with undiagnosed HIV infection? An estimate for Italy, based on surveillance data
Identifieur interne : 000048 ( Main/Exploration ); précédent : 000047; suivant : 000049How many people are living with undiagnosed HIV infection? An estimate for Italy, based on surveillance data
Auteurs : Alessia Mammone ; Patrizio Pezzotti [Italie] ; Vincenza Regine [Italie] ; Laura Camoni [Italie] ; Vincenzo Puro ; Giuseppe Ippolito ; Barbara Suligoi [Italie] ; Enrico GirardiSource :
- AIDS (London, England) [ 0269-9370 ] ; 2016.
Abstract
To estimate the size and characteristics of the undiagnosed HIV population in Italy in 2012 applying a method that does not require surveillance data from the beginning of the HIV epidemic.
We adapted the method known as ‘London method 2’; the undiagnosed population is estimated as the ratio between the estimated annual number of simultaneous HIV/clinical AIDS diagnoses and the expected annual progression rate to clinical AIDS in the undiagnosed HIV population; the latter is estimated using the CD4+ cell count distribution of asymptomatic patients reported to surveillance. Under-reporting/ascertainment of new diagnoses was also considered. Also, the total number of people living with HIV was estimated.
The undiagnosed HIV population in 2012 was 13 729 (95% confidence interval: 12 152–15 592), 15 102 (13 366–17 151) and 16 475 (14 581–18 710), assuming no under-reporting/ascertainment, 10 and 20% of under-reporting/ascertainment, respectively. The percentage of undiagnosed cases was higher among HIV people aged below 25 years (25–28%), MSM (16–19%) and people born abroad (16–19%), whereas it was small among injection drug users (3%).
The estimate of people in Italy with undiagnosed HIV in 2012 was in a plausible range of 12 000–18 000 cases, corresponding to 11–13% of the overall prevalence. The method is straightforward to implement only requiring annual information from the HIV surveillance system about CD4+ cell count and clinical stage at HIV diagnosis. Thus, it could be used to monitor if a certain prevention initiative lead to the reduction of the undiagnosed HIV population over time. It can also be easily implemented in other countries collecting the same basic information from the HIV surveillance system.
Url:
DOI: 10.1097/QAD.0000000000001034
PubMed: 26807973
PubMed Central: 4819953
Affiliations:
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Spallanzani’ National Institute for Infectious Diseases, IRCCS</nlm:aff><wicri:noCountry code="subfield">IRCCS</wicri:noCountry></affiliation></author><author><name sortKey="Pezzotti, Patrizio" sort="Pezzotti, Patrizio" uniqKey="Pezzotti P" first="Patrizio" last="Pezzotti">Patrizio Pezzotti</name><affiliation wicri:level="3"><nlm:aff id="aff2">Istituto Superiore di Sanità, Rome, Italy.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Italie</country><wicri:regionArea>Istituto Superiore di Sanità, Rome</wicri:regionArea><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author><author><name sortKey="Regine, Vincenza" sort="Regine, Vincenza" uniqKey="Regine V" first="Vincenza" last="Regine">Vincenza Regine</name><affiliation wicri:level="3"><nlm:aff id="aff2">Istituto Superiore di Sanità, Rome, Italy.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Italie</country><wicri:regionArea>Istituto Superiore di Sanità, Rome</wicri:regionArea><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author><author><name sortKey="Camoni, Laura" sort="Camoni, Laura" uniqKey="Camoni L" first="Laura" last="Camoni">Laura Camoni</name><affiliation wicri:level="3"><nlm:aff id="aff2">Istituto Superiore di Sanità, Rome, Italy.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Italie</country><wicri:regionArea>Istituto Superiore di Sanità, Rome</wicri:regionArea><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author><author><name sortKey="Puro, Vincenzo" sort="Puro, Vincenzo" uniqKey="Puro V" first="Vincenzo" last="Puro">Vincenzo Puro</name><affiliation><nlm:aff id="aff1">‘L. Spallanzani’ National Institute for Infectious Diseases, IRCCS</nlm:aff><wicri:noCountry code="subfield">IRCCS</wicri:noCountry></affiliation></author><author><name sortKey="Ippolito, Giuseppe" sort="Ippolito, Giuseppe" uniqKey="Ippolito G" first="Giuseppe" last="Ippolito">Giuseppe Ippolito</name><affiliation><nlm:aff id="aff1">‘L. Spallanzani’ National Institute for Infectious Diseases, IRCCS</nlm:aff><wicri:noCountry code="subfield">IRCCS</wicri:noCountry></affiliation></author><author><name sortKey="Suligoi, Barbara" sort="Suligoi, Barbara" uniqKey="Suligoi B" first="Barbara" last="Suligoi">Barbara Suligoi</name><affiliation wicri:level="3"><nlm:aff id="aff2">Istituto Superiore di Sanità, Rome, Italy.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Italie</country><wicri:regionArea>Istituto Superiore di Sanità, Rome</wicri:regionArea><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author><author><name sortKey="Girardi, Enrico" sort="Girardi, Enrico" uniqKey="Girardi E" first="Enrico" last="Girardi">Enrico Girardi</name><affiliation><nlm:aff id="aff1">‘L. Spallanzani’ National Institute for Infectious Diseases, IRCCS</nlm:aff><wicri:noCountry code="subfield">IRCCS</wicri:noCountry></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">26807973</idno><idno type="pmc">4819953</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4819953</idno><idno type="RBID">PMC:4819953</idno><idno type="doi">10.1097/QAD.0000000000001034</idno><date when="2016">2016</date><idno type="wicri:Area/Pmc/Corpus">000077</idno><idno type="wicri:Area/Pmc/Curation">000077</idno><idno type="wicri:Area/Pmc/Checkpoint">000038</idno><idno type="wicri:Area/Ncbi/Merge">000400</idno><idno type="wicri:Area/Ncbi/Curation">000400</idno><idno type="wicri:Area/Ncbi/Checkpoint">000400</idno><idno type="wicri:doubleKey">0269-9370:2016:Mammone A:how:many:people</idno><idno type="wicri:Area/Main/Merge">000048</idno><idno type="wicri:Area/Main/Curation">000048</idno><idno type="wicri:Area/Main/Exploration">000048</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">How many people are living with undiagnosed HIV infection? An estimate for Italy, based on surveillance data</title><author><name sortKey="Mammone, Alessia" sort="Mammone, Alessia" uniqKey="Mammone A" first="Alessia" last="Mammone">Alessia Mammone</name><affiliation><nlm:aff id="aff1">‘L. Spallanzani’ National Institute for Infectious Diseases, IRCCS</nlm:aff><wicri:noCountry code="subfield">IRCCS</wicri:noCountry></affiliation></author><author><name sortKey="Pezzotti, Patrizio" sort="Pezzotti, Patrizio" uniqKey="Pezzotti P" first="Patrizio" last="Pezzotti">Patrizio Pezzotti</name><affiliation wicri:level="3"><nlm:aff id="aff2">Istituto Superiore di Sanità, Rome, Italy.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Italie</country><wicri:regionArea>Istituto Superiore di Sanità, Rome</wicri:regionArea><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author><author><name sortKey="Regine, Vincenza" sort="Regine, Vincenza" uniqKey="Regine V" first="Vincenza" last="Regine">Vincenza Regine</name><affiliation wicri:level="3"><nlm:aff id="aff2">Istituto Superiore di Sanità, Rome, Italy.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Italie</country><wicri:regionArea>Istituto Superiore di Sanità, Rome</wicri:regionArea><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author><author><name sortKey="Camoni, Laura" sort="Camoni, Laura" uniqKey="Camoni L" first="Laura" last="Camoni">Laura Camoni</name><affiliation wicri:level="3"><nlm:aff id="aff2">Istituto Superiore di Sanità, Rome, Italy.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Italie</country><wicri:regionArea>Istituto Superiore di Sanità, Rome</wicri:regionArea><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author><author><name sortKey="Puro, Vincenzo" sort="Puro, Vincenzo" uniqKey="Puro V" first="Vincenzo" last="Puro">Vincenzo Puro</name><affiliation><nlm:aff id="aff1">‘L. Spallanzani’ National Institute for Infectious Diseases, IRCCS</nlm:aff><wicri:noCountry code="subfield">IRCCS</wicri:noCountry></affiliation></author><author><name sortKey="Ippolito, Giuseppe" sort="Ippolito, Giuseppe" uniqKey="Ippolito G" first="Giuseppe" last="Ippolito">Giuseppe Ippolito</name><affiliation><nlm:aff id="aff1">‘L. Spallanzani’ National Institute for Infectious Diseases, IRCCS</nlm:aff><wicri:noCountry code="subfield">IRCCS</wicri:noCountry></affiliation></author><author><name sortKey="Suligoi, Barbara" sort="Suligoi, Barbara" uniqKey="Suligoi B" first="Barbara" last="Suligoi">Barbara Suligoi</name><affiliation wicri:level="3"><nlm:aff id="aff2">Istituto Superiore di Sanità, Rome, Italy.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Italie</country><wicri:regionArea>Istituto Superiore di Sanità, Rome</wicri:regionArea><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author><author><name sortKey="Girardi, Enrico" sort="Girardi, Enrico" uniqKey="Girardi E" first="Enrico" last="Girardi">Enrico Girardi</name><affiliation><nlm:aff id="aff1">‘L. Spallanzani’ National Institute for Infectious Diseases, IRCCS</nlm:aff><wicri:noCountry code="subfield">IRCCS</wicri:noCountry></affiliation></author></analytic><series><title level="j">AIDS (London, England)</title><idno type="ISSN">0269-9370</idno><idno type="eISSN">1473-5571</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Objective:</title><p>To estimate the size and characteristics of the undiagnosed HIV population in Italy in 2012 applying a method that does not require surveillance data from the beginning of the HIV epidemic.</p></sec><sec sec-type="methods"><title>Methods:</title><p>We adapted the method known as ‘London method 2’; the undiagnosed population is estimated as the ratio between the estimated annual number of simultaneous HIV/clinical AIDS diagnoses and the expected annual progression rate to clinical AIDS in the undiagnosed HIV population; the latter is estimated using the CD4<sup>+</sup> cell count distribution of asymptomatic patients reported to surveillance. Under-reporting/ascertainment of new diagnoses was also considered. Also, the total number of people living with HIV was estimated.</p></sec><sec sec-type="results"><title>Results:</title><p>The undiagnosed HIV population in 2012 was 13 729 (95% confidence interval: 12 152–15 592), 15 102 (13 366–17 151) and 16 475 (14 581–18 710), assuming no under-reporting/ascertainment, 10 and 20% of under-reporting/ascertainment, respectively. The percentage of undiagnosed cases was higher among HIV people aged below 25 years (25–28%), MSM (16–19%) and people born abroad (16–19%), whereas it was small among injection drug users (3%).</p></sec><sec sec-type="conclusion"><title>Conclusion:</title><p>The estimate of people in Italy with undiagnosed HIV in 2012 was in a plausible range of 12 000–18 000 cases, corresponding to 11–13% of the overall prevalence. The method is straightforward to implement only requiring annual information from the HIV surveillance system about CD4<sup>+</sup> cell count and clinical stage at HIV diagnosis. Thus, it could be used to monitor if a certain prevention initiative lead to the reduction of the undiagnosed HIV population over time. It can also be easily implemented in other countries collecting the same basic information from the HIV surveillance system.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Mcgarrigle, Ca" uniqKey="Mcgarrigle C">CA McGarrigle</name></author><author><name sortKey="Cliffe, S" uniqKey="Cliffe S">S Cliffe</name></author><author><name sortKey="Copas, Aj" uniqKey="Copas A">AJ Copas</name></author><author><name sortKey="Mercer, Ch" uniqKey="Mercer C">CH Mercer</name></author><author><name sortKey="De Angelis, D" uniqKey="De Angelis D">D De Angelis</name></author><author><name sortKey="Fenton, Ka" uniqKey="Fenton K">KA Fenton</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Campsmith, Ml" uniqKey="Campsmith M">ML Campsmith</name></author><author><name sortKey="Rhodes, Ph" uniqKey="Rhodes P">PH Rhodes</name></author><author><name sortKey="Hall, Hi" uniqKey="Hall H">HI 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J">J Jansson</name></author><author><name sortKey="Kerr, Cc" uniqKey="Kerr C">CC Kerr</name></author><author><name sortKey="Mallitt, Ka" uniqKey="Mallitt K">KA Mallitt</name></author><author><name sortKey="Wu, J" uniqKey="Wu J">J Wu</name></author><author><name sortKey="Gray, Rt" uniqKey="Gray R">RT Gray</name></author><author><name sortKey="Wilson, Dp" uniqKey="Wilson D">DP Wilson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Van Sighem, A" uniqKey="Van Sighem A">A van Sighem</name></author><author><name sortKey="Nakagawa, F" uniqKey="Nakagawa F">F Nakagawa</name></author><author><name sortKey="De Angelis, D" uniqKey="De Angelis D">D De Angelis</name></author><author><name sortKey="Quinten, C" uniqKey="Quinten C">C Quinten</name></author><author><name sortKey="Bezemer, D" uniqKey="Bezemer D">D Bezemer</name></author><author><name sortKey="De Coul, Eo" uniqKey="De Coul E">EO de Coul</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Birrell, Pj" uniqKey="Birrell P">PJ Birrell</name></author><author><name sortKey="Gill, On" uniqKey="Gill O">ON Gill</name></author><author><name sortKey="Delpech, Vc" uniqKey="Delpech V">VC Delpech</name></author><author><name sortKey="Brown, Ae" uniqKey="Brown A">AE Brown</name></author><author><name sortKey="Desai, S" uniqKey="Desai S">S Desai</name></author><author><name sortKey="Chadborn, Tr" uniqKey="Chadborn T">TR Chadborn</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Van Sighem, A" uniqKey="Van Sighem A">A van Sighem</name></author><author><name sortKey="Vidondo, B" uniqKey="Vidondo B">B Vidondo</name></author><author><name sortKey="Glass, Tr" uniqKey="Glass T">TR Glass</name></author><author><name sortKey="Bucher, Hc" uniqKey="Bucher H">HC Bucher</name></author><author><name sortKey="Vernazza, P" uniqKey="Vernazza P">P Vernazza</name></author><author><name sortKey="Gebhardt, M" uniqKey="Gebhardt M">M Gebhardt</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Phillips, A" uniqKey="Phillips A">A Phillips</name></author><author><name sortKey="Pezzotti, P" uniqKey="Pezzotti P">P Pezzotti</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Italie</li></country><region><li>Latium</li></region><settlement><li>Rome</li></settlement></list><tree><noCountry><name sortKey="Girardi, Enrico" sort="Girardi, Enrico" uniqKey="Girardi E" first="Enrico" last="Girardi">Enrico Girardi</name><name sortKey="Ippolito, Giuseppe" sort="Ippolito, Giuseppe" uniqKey="Ippolito G" first="Giuseppe" last="Ippolito">Giuseppe Ippolito</name><name sortKey="Mammone, Alessia" sort="Mammone, Alessia" uniqKey="Mammone A" first="Alessia" last="Mammone">Alessia Mammone</name><name sortKey="Puro, Vincenzo" sort="Puro, Vincenzo" uniqKey="Puro V" first="Vincenzo" last="Puro">Vincenzo Puro</name></noCountry><country name="Italie"><region name="Latium"><name sortKey="Pezzotti, Patrizio" sort="Pezzotti, Patrizio" uniqKey="Pezzotti P" first="Patrizio" last="Pezzotti">Patrizio Pezzotti</name></region><name sortKey="Camoni, Laura" sort="Camoni, Laura" uniqKey="Camoni L" first="Laura" last="Camoni">Laura Camoni</name><name sortKey="Regine, Vincenza" sort="Regine, Vincenza" uniqKey="Regine V" first="Vincenza" last="Regine">Vincenza Regine</name><name sortKey="Suligoi, Barbara" sort="Suligoi, Barbara" uniqKey="Suligoi B" first="Barbara" last="Suligoi">Barbara Suligoi</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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