Document 2351
 DOCN  M94A2351
 TI    Combined surveillance of advanced HIV disease. Lazio AIDS Coll Group.
 DT    9412
 AU    Abeni DD; Perucci CA; Ancona C; Brancato G; Peano RM; Sangalli M;
       Epidemiology Unit, Lazio Region Health Authority, Roma, Italia.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(1):324 (abstract no. PC0227). Unique
       Identifier : AIDSLINE ICA10/94370224
 AB    OBJECTIVE: To provide a model of independent surveillance of severe
       immunosuppression (SI) and AIDS. METHODS: Since May 1992, a
       laboratory-based surveillance system (SS) on SI [< 200 CD4+/microL] is
       active in the Lazio Region (approx. 5,000,000 residents), independently
       from the AIDS registry [European definition, 1993]. Record linkage
       between the two SSs yields surveillance according to the CDC 1993 AIDS
       definition. In the study period (May 92-Oct 93), subjects were
       classified according to the first SS they were reported to. Subjects
       reported in the same semester to both SSs were classified as AIDS[Eur].
       RESULTS: A total of 1768 subjects (AIDS-CDC93) was reported to the two
       SSs: 732 AIDS[Eur] and 1036 SI cases. The overall AIDS-CDC93/AIDS[Eur]
       ratio was 2.4, ranging from 2.3 to 2.6 in the 3 semesters. SI subjects
       were more likely to be females (26.5% vs 22.8%) and < 35 yrs old (64.9%
       vs 58.4%), and less likely to have < 100 CD4+/microL (39.4% vs 63.2%)
       than AIDS[Eur] subjects. Only 67/1768 (3.8%) subjects had > 200
       CD4+/microL. CONCLUSIONS: We demonstrate the feasibility of combined
       surveillance of SI and AIDS: with very limited additional resources we
       obtain a much more complete picture of the extent of advanced HIV
       disease, essential for assessing real health care needs and planning
       resource allocation. In our model, subjects with SI (including
       asymptomatics) are granted access to benefits and entitlement programs
       without being labelled as having AIDS. Furthermore, no information is
       lost on the first clinical manifestation of AIDS, ensuring comparability
       with previous surveillance. We propose that our model be adopted in the
       EEC and in all Countries where CD4+ counts are widely available.
 DE    Acquired Immunodeficiency Syndrome/*EPIDEMIOLOGY/IMMUNOLOGY  Adult
       Cross-Sectional Studies  Female  Human  Incidence  Italy/EPIDEMIOLOGY
       *Leukocyte Count  Male  *Population Surveillance  Registries/STATISTICS
       & NUMER DATA  T-Lymphocytopenia, Idiopathic CD4-Positive/*EPIDEMIOLOGY/
       IMMUNOLOGY  T4 Lymphocytes/*IMMUNOLOGY  MEETING ABSTRACT

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