Treść książki
Przejdź do opcji czytnikaPrzejdź do nawigacjiPrzejdź do informacjiPrzejdź do stopki
EpidemiologyofHIVinfectioninPolandinlightofthesituationinEuropeand
worldwide
EwaFirląg-Burkacka,EwaSiwak,JoannaKubicka,JustynaDominikaKowalska,
JadwigaGizińska,AndrzejHorban
Acquiredimmunodeficiencysyndrome(AIDS)resultsfrominfectionwiththehumanimmunodeficiency
virus(HIV)andischaracterizedbyimmunologicaldisorders,aconsequenceofdysfunctionandadecrease
inthenumberofCD4+lymphocytes.Clinically,AIDSischaracterizedbythecoexistenceofmultiple
comorbidconditions,opportunisticdiseases,neurologicaldisorders,psychologicaldisorders,progressive
exploitationoftheorganism,developmentofcancers,aswellasdiseasesofskinandmucosawithatypical
presentation(Mroczkowski,2012).
ThefirstcaseofAIDSwasdescribedintheUSAin1981.Fromthemid-80s,newcaseswereobserved
amongtheyoungindividuals,whichweredifficulttodiagnoseandweretreatment-resistant,withfast
progressleadingtodeath.AnalysisofthefrozenbloodsamplesinNewYorkCityandSanFranciscoshowed
thatHIVreachedtheUSAinthelate70s.In4.5%ofthebloodsamplescollectedfrommeninSanFrancisco,
theanti-HTLV-III/LAVantibodies(thenameofthevirusbeforetheintroductionof“HIV”)wereidentified.
Similarantibodiesweredetectedinthe80sinthebloodsamplescollectedinSwitzerland,andlaterin1983
inUganda.Currently,itisbelievedthattheHIV/AIDSepidemicbeganinAfrica,thenmovedtotheUSAand
othercountriesofNorthAmerica,andlaterreachedEuropeandAsia.ThefirstHIVinfectionwasreported
inPolandin1985(Mroczkowski,2012).
HIVcanbetransmittedinthefollowingways,
sexualintercourse(hetero-,homo-andbisexual),
withblood(sharingneedlesfordruguse,expositionofthemucosaandopenwoundsofaninfected
person,bloodandbloodsubstitutestransfusion),
mother-to-child(mainlyduringtheperinatalperiodandbreast-feeding).
AccordingtotheUNAIDSreportfrom2013,thenumberofpeoplelivingwithHIVinfectionacrossthe
worldhasbeenestimatedat78millionsincethebeginningoftheepidemic,with39milliondeathsdueto
AIDS-relatedcomplications(UNAIDS,2014).
Inrecentyears,therehasbeenadeclineinthenumberofnewHIVinfectiondiagnosesamongadults.
In2009,therewere2.5millionnewdiagnoses,whilein2013-2.1million.ThenumberofAIDS-related
deathsisalsodecreasing,i.e.,from2millionin2009to1.5millionin2013.Thehighestnumberofdeaths
wasrecordedin2005,whenitreached2.4million(UNAIDS,2014).
TheHIVepidemichastakendifferentformsworldwide,dependingontheprevalenceofinfection,
availabilityofhealthcareandantiretroviraltreatment(ARV).InAfrica,themajorityofpeopleinfectedwith
HIVliveinSouthAfrica-approx.6.3million.Heterosexualrelationshipisthepredominantwayof
infection,withwomenconstitutinghalfoftheHIV-infectedpopulation.Thisgroundsthefactthatthe
secondmostcommonHIVinfectiontransmissionwayisfrommothertochild.Lately,intheAfrican
countriessouthoftheSahara(e.g.,Senegal),sexualcontactsamongmenwhohavesexwithmen(MSM)
(UNAIDS,2014)arethepredominantrouteofinfection.
InSouthandSoutheastAsia,theHIVepidemiologyisratherstable,althoughdifferentbetweenthe
countries.InseveralcountrieslikeIndia,Nepal,orThailand,adeclineinnewinfectionsby25%hasbeen
observedsince2009,whileinBangladeshandthePhilippinesinthesametimeperioda20%increasehas
beennoted.
InAsia,HIVinfectionismostcommonlyfoundamongdrugusersusinginjections.Thesecondmost
commonwayofinfectionaresexualservicesandmenhavingsexwithmen.ItisestimatedthatinAsia4.5
millionpeopleshowintravenousdruguse,halfofthembeinglocatedinChina(UNAIDS,2014).
IntheCaribbean,theescalationofHIVinfectionproblemvariesbetweentheregions.Thelowestrateof
HIVinfectionisobservedinCuba,whilethehighestintheBahamas.Moreover,thereisanincreaseinthe
numberofHIV-infectedwomen.Itisestimatedthatwomencomprisemorethanhalfoftheinfectedpeople
inthisregion.In2013,therewere250,000peoplelivingwithHIVintheCaribbean,including12,000
women.SexualintercourseisthemainwayofHIVtransmissionintheCaribbean.
InSouthandCentralAmerica,morethan1.5millionpeoplelivewithHIV.Outofthose,94,000were
diagnosedin2013.InfectionpredominatesamongMSM,e.g.,inPeruitaccountsfor56%ofcases.The
11
