HIV diagnoses in children and adolescents: key issues in Europe and different age groups

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


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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

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Source: UNAIDS 2014 HIV and AIDS estimates, July 2015.http://data.unicef.org/hiv-aids/adolescents-young-people.html#sthash.KiNdOThS.dpuf


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HIV diagnoses among children and adolescents (0-19 years), EU/EEA

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• 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


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In EU/EEA, HIV diagnoses among children and adolescents (0-19 years)

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• 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


Several questions to answer: • Main modes of transmission? • Trends? • Demographic characteristics? • Public health implications?


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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



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Trends of HIV diagnoses among children and adolescents (0-19 years), by mode of transmission, 2005-2014, EU/EEA

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Source: The European Surveillance System, 30 EU/EEA reporting countries Note: Italy and Spain not included due to changes in surveillance systems


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HIV diagnoses among 15-19 years olds, by region of origin and transmission, EU/EEA,2005-2014

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Born in reporting country Foreign-born


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

2005 2006 2007 2008 2009 2010 2011 2012 2013 20140

20

40

60

80

100

120

140

160

180

HETERO IDU MSMMTCT NOSO&trans UNK


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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


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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)

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• 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


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


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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.



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



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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


• 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


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HIV-MTCT foreign-born cases diagnosed in EU/EEAby region of origin and year of diagnosis in the reporting country

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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]


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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)

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*ECDC Technical report. Antenatal screening for HIV, hepatitis B, syphilis and rubella susceptibility in the EU/EEA . Stockholm: ECDC; 2016.


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Thank you!Acknowledgements • Anastasia Pharris, ECDC • EU/EEA HIV/AIDS surveillance network for providing data to TESSy

Contact: [email protected]

07/10/2016

mailto:[email protected]

Health & Medicine

HIV diagnoses in children and adolescents: key issues in Europe and different age groups