AEGiS-13IAC: National surveillance provides timely information on uptake and impact of HAART in Scotland.

13th International AIDS Conference

Durban, South Africa - July 9-July 14, 2000

National surveillance provides timely information on uptake and impact of HAART in Scotland.

Int Conf AIDS 2000 Jul 9-14; 13:(abstract no. ThOrC745)

Goldberg Dr, Allardice G, Shaw L, Codere G
Dr. D. Goldberg, SCIEH, Clifton House, Clifton Place, Glasgow G3 7LN, United Kingdom, Tel.: +0141 300 1100, Fax: +0141 300 1170, E-mail: david.goldberg@scieh.csa.scot.nhs.uk

BACKGROUND: It is essential that information about the uptake and impact of HAART is routinely available to those responsible for purchasing and providing health care for HIV infected persons. Accordingly, a new approach to the surveillance of known HIV infected individuals in Scotland has been adopted by the Scottish Centre for Infection and Environmental Health (SCIEH).

METHODS: In 1992, SCIEH, in association with immunology laboratories, developed a surveillance system which involved the collection of CD4 count data on all HIV infected persons in Scotland; in 1996, the system was extended to collect data on the number of antiretroviral agents administered to patients. This paper demonstrates the system's capability and value. For all persons undergoing immunological monitoring in the consecutive years a) 1994/95 (n = 797), b) 1995/96 (n = 757), c) 1996/97 (n = 779), d) 1997/98 (n = 911), and e) 1998/99 (n = 983), the median differences between individuals' first CD4 counts in each of the two years and by the highest number of treatments they were administered at any time during the interval between the two counts, were calculated.

RESULTS: The median differences in CD4 counts were -35, -21, +3, +12, and +21 for a) - e) respectively. In the 1998/99 cohort, the median difference in CD4 count for those on no therapy was -36 (95% CI: -58, -15), and on triple therapy +45 (95% CI: +29, +60); 70% of all individuals under monitoring had received three or more agents and 77%, two or more. The corresponding rates for the 1996/97 and 1997/98 cohorts were 33%/63% and 58%/73% respectively.

CONCLUSION: These data provide an up-to-the-minute assessment of the impact and uptake of therapy at a national level. They have convinced health care purchasers of the benefits of making HAART available to all those eligible for treatment in Scotland and are being used to assess current and future requirements.

Keywords: AEGIS, Antiretroviral Therapy, Highly Active, CD4 Lymphocyte Count, HIV Infections, HIV, Anti-HIV Agents, HIV Seropositivity, Federal Government, Scotland, Human, epidemiology
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