Document 2106
 DOCN  M94A2106
 TI    The changing spectrum of AIDS index diseases in Canada.
 DT    9412
 AU    Schechter MT; Sutherland D; Hogg RS; Strathdee SA; Le TN; O'Shaughnessy
       MV; Montaner JS; BC Centre for Excellence in HIV/AIDS, Vancouver,
       Canada.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(1):38 (abstract no. 124C). Unique
       Identifier : AIDSLINE ICA10/94370469
 AB    OBJECTIVE: To describe the changing spectrum of AIDS index diseases in
       Canada from 1981 to 1991. METHODS: The present analysis was based on the
       AIDS index diseases reported to the Bureau of HIV/AIDS Epidemiology as
       of March 1993. Analysis was restricted to persons aged 15-64 years who
       were diagnosed prior to December 31, 1991. The annual number of AIDS
       cases were adjusted for reporting delay; disease-specific incidence
       rates were calculated by standardizing rates to the 1991 Canadian
       population. Linear regressions were performed to test the changes in
       annual incidence rates for each index disease. Reported p-values are
       two-sided. RESULTS: A total of 6,641 adult AIDS cases were examined:
       6,304 (94.9%) males, 337 (5.1%) females. As seen in the figure, the
       incidence of PCP peaked in 1989 with a rate of 3.18 per 100,000,
       declining to 2.74 per 100,000 in 1991 (p = 0.894). Similarly the rate of
       KS stabilized during this interval from 1.06 per 100,000 in 1987 to 1.14
       per 100,000 in 1991 (p = 0.189). In contrast, the rates of all other
       AIDS defining illnesses increased from 1.48 per 100,000 in 1987 to 3.43
       per 100,000 in 1991 (p = 0.001). Significant rate increases were
       observed for esophageal candidiasis, cytomegalovirus diseases, wasting
       syndrome, toxoplasmosis, and Mycobacterium avium complex disease.
       Changes in incidence over this period were especially marked for
       esophageal candidiasis where rates increased from 0.11 to 1.27 per
       100,000 (p < 0.001), and for CMV where rates increased from 0.01 to 0.40
       per 100,000 (p = 0.002). CONCLUSIONS: These findings highlight the
       importance of developing specific strategies to deal with emerging
       AIDS-associated diseases. Our data provide a cautionary note to
       practicing clinicians with regard to the relative widening of the
       spectrum of HIV index diseases. TABULAR DATA, SEE ABSTRACT VOLUME.
 DE    Acquired Immunodeficiency Syndrome/*EPIDEMIOLOGY  Adolescence  Adult
       AIDS-Related Opportunistic Infections/EPIDEMIOLOGY  Canada/EPIDEMIOLOGY
       Female  Human  Incidence  Male  Middle Age  Pneumonia, Pneumocystis
       carinii/EPIDEMIOLOGY  Regression Analysis  Sarcoma,
       Kaposi's/EPIDEMIOLOGY  MEETING ABSTRACT

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).