Prevalence of HIV among injection drug users in Georgia

Chikovani, Ivdity; Goguadze, Ketevan; Ranade, Sudit; Wertlieb, Mollie; Rukhadze, Natia; Gotsadze, George

doi:10.1186/1758-2652-14-9

Cited by 6 publications

(7 citation statements)

References 10 publications

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“…Thus the higher mortality among IDUs in our cohort did not result from issues of ART access, but rather from presenting with more advanced disease than non-IDUs. Taking into account the very low HIV testing coverage of this population, 27 it is not surprising that more IDUs were diagnosed late than non-IDUs (55% vs. 40%, p < 0.0001). In addition, TB was much more common among persons who had a history of drug abuse (27.9% vs. 13.5%, p < 0.0001) and IDUs were more likely to be coinfected with HCV (68.6% vs. 21.4%, p < 0.0001).…”

Section: Discussionmentioning

confidence: 93%

Mortality and Causes of Death Among HIV-Infected Individuals in the Country of Georgia: 1989–2012

Chkhartishvili

Sharvadze

Chokoshvili

et al. 2014

AIDS Research and Human Retroviruses

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Since 2004, the country of Georgia has provided antiretroviral therapy (ART) to all patients in need. A nationwide retrospective cohort study was conducted to assess the effect of universal access to ART on patterns of mortality and causes of death among HIV-infected individuals in Georgia. All known HIV-infected adult individuals (age ‡ 18 years) diagnosed from 1989 through 2012 were included. Rates and causes of death were determined using routinely collected data from the national HIV/AIDS database. Causes of death were classified according to the Coding of Death in HIV (CoDe) protocol. Between 1989 and 2012, 3,554 HIV-infected adults were registered in Georgia contributing to 13,572 person-years (PY) of follow-up. A total of 779 deaths were registered during follow-up. The mortality rate peaked in 2004 with 10.74 deaths per 100 PY (95% CI: 7.92-14.24) and significantly decreased after the universal availability of ART to 4.02 per 100 PY (95% CI: 3.28-4.87) in 2012. In multivariate analysis the strongest predictor of mortality was having AIDS at the time of HIV diagnosis (hazard ratio: 5.69, 95% CI: 4.72-6.85). AIDS-related diseases accounted for the majority of deaths (n = 426, 54.7%). Tuberculosis (TB) was the leading cause of death accounting for 21% of the total deaths reported. Universal access to ART significantly reduced mortality among HIV-infected patients in Georgia. However, overall mortality rates remain high primarily due to late diagnosis, and TB remains a significant cause of death. Improving rates of early HIV diagnosis and ART initiation may further decrease mortality as well as prevent new HIV and TB infections.

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Section: Discussionmentioning

confidence: 93%

Mortality and Causes of Death Among HIV-Infected Individuals in the Country of Georgia: 1989–2012

Chkhartishvili

Sharvadze

Chokoshvili

et al. 2014

AIDS Research and Human Retroviruses

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“…Undiagnosed HIV infection is a world‐wide problem, with estimates of the percentage of HIV‐infected individuals who are undiagnosed ranging from 20% in the USA to 60% in sub‐Saharan Africa . The significant gap in the stage of HIV testing/diagnosis in Georgia is the result of low testing coverage of key populations at risk and missed opportunities to diagnose HIV infection in health care settings . HIV testing efforts, including community‐based and health care‐based strategies , need to be substantially expanded in Georgia in order to reduce the number of people unaware of their infection.…”

Section: Discussionmentioning

confidence: 99%

The cascade of care in the Eastern European country of Georgia

et al. 2014

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Objectives Individual and public health benefits of antiretroviral therapy (ART) rely on successful engagement of HIV patients in care. We aimed to evaluate HIV care continuum in the Eastern European country of Georgia. Methods The analysis included all adult (age ≥18 years) HIV patients diagnosed in Georgia from 1989 through June 2012. Data was extracted from the national HIV/AIDS database as of October 1, 2012. The following stages of HIV care continuum were quantified: HIV infected, HIV diagnosed, linked to care, retained in care, eligible for ART and virologically suppressed. Results Of cumulative 3,295 cases of adult HIV infection reported in Georgia, 2,545 HIV patients were known to be alive as of October 1, 2012, which is 52% of estimated 4,900 persons living with HIV in the country. Among 2,545 HIV diagnosed persons 2,135 (84%) were linked to care and 1,847 (73%) were retained in care. Of 1,446 patients eligible for ART, 1273 (88%) were on treatment and 985 (77%) of them had viral load <400 copies/ml. Overall, 39% of those diagnosed and 20% of those infected had a suppressed viral load. Conclusions Findings of our analysis demonstrate that majority of diagnosed HIV patients are retained in care. Loss of patients occurs at each step of the HIV care continuum, but the major gap is at the stage of HIV diagnosis. Reducing the number of persons living with undiagnosed HIV and simultaneously enhancing engagement in continuous care will be critical to achieve maximum individual and public health benefits of ART.

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“…This issue is of particular concern in the major risk group of IDUs, who report extremely low HIV testing uptake. 4 FRR obtained in our study was very high, resulting in greater uncertainty around incidence estimates. The high FRR value was due to a high proportion of patients with AIDS or low CD4 cell counts in the sample.…”

Section: Discussionmentioning

confidence: 69%

“…Latest BBS data indicate that HIV prevalences among IDUs and FSWs remain relatively low at −3% and 1%, respectively. 4,5 There was significant increase in HIV prevalence among MSM from 3.7% reported in 2007 to 13% in 2012. 6,7 Georgia has made substantial progress in providing ART.…”

Section: Introductionmentioning

confidence: 96%

Estimating HIV incidence in eastern European country of Georgia: 2010–2012

et al. 2014

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The knowledge of HIV incidence is essential to better understand patterns of HIV transmission. We estimated HIV incidence over 2010-2012 in the eastern European country of Georgia. Mathematical modeling using Spectrum software and assay-based recent infection testing algorithm were applied. The study included 1155 HIV patients newly diagnosed in 2010-2012 (84% of total diagnoses). Of them, 231 were determined to be recently infected on the recent infection testing algorithm. The proportion of recent cases did not differ between 2010, 2011 and 2012 (20.4% vs. 19.4% vs. 20.2%, p = 0.94). Both study methods derived comparable estimates ranging from 0.2 to 0.3%, which is up to twice as high as rates of new diagnosis reported in the same period. Despite the relatively stable HIV incidence over 2010-2012, the epidemic continues to grow because of the increasing gap between HIV-infected and diagnosed persons. Increased efforts are needed to reduce the number of people with undiagnosed HIV.

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Prevalence of HIV among injection drug users in Georgia

Cited by 6 publications

References 10 publications

Mortality and Causes of Death Among HIV-Infected Individuals in the Country of Georgia: 1989–2012

Mortality and Causes of Death Among HIV-Infected Individuals in the Country of Georgia: 1989–2012

The cascade of care in the Eastern European country of Georgia

Estimating HIV incidence in eastern European country of Georgia: 2010–2012

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