1st National Conference Human Retroviruses and Related Infections Washington, DC - December 12-16, 1993

Natl Conf Hum Retrovir Relat Infect 1993 Dec 12-16;1: (abstract no. 23)

Jansen R, Satten G, Petersen L
Centers for Disease Control and Prevention, Atlanta, GA

OBJECTIVES: To estimate trends in incidence of HIV infection from 1988 through 1991 among communities served by U.S. acute care hospitals.

METHODS: Blood specimens from patients (greater than 15 years old) with conditions not associated with HIV at 15 U.S. hospitals were tested anonymously for antibody to HIV- 1. Because data from cohort studies have shown that β2-microglobulin (B2M) progressively increases with increasing length of HIV infection, we estimated trends in recent HIV infection by determining the proportion of HIV-positive patients with low B2M levels (less than or equal to 1.8 mg/l) as measured by EIA (Pharmacia). Because most of the changes in trends occurred among women, we estimated incidence only for this group. To estimate incidence among women, we estimated the baseline incidence in 1988 for each hospital and used a common yearly proportional change obtained from backward elimination logistic regression.

RESULTS: Of 2097 specimens assayed for B2M, 742 (35%) had low B2M levels. Prevalence of low B2M levels increased among HIV-infected men in 3 of 15 hospitals, and among HIV- infected women in 8 of 13 hospitals. In 1990, the male to female ratio of prevalence of recent infection was ≤ 1 in 3 hospitals. Incidence of HIV infection in 1990 among women seeking medical care for conditions unrelated to HIV infection ranged from 0.2 per 1000 at a hospital in Denver to 18 per 1000 at hospitals in the Bronx and Newark.

CONCLUSION: Among women, the prevalence of recent HIV infection increased from 1988 through 1991. The incidence of HIV infection may now be higher among women than among men seeking medical care at some U.S. hospitals.

Keywords: Acquired Immunodeficiency Syndrome, Cohort Studies, Cross-Sectional Studies, Female, HIV Infections, HIV Seropositivity, HIV-1, Hematologic Tests, Hospitals, Humans, Incidence, Male, Prevalence, United States

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1993-12-12
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