HIV incidence in Republic of Karelia. Chemoprevention of mother-to-child transmission of HIV_ eng

HIV incidence in Republic of Karelia.
Chemoprevention of mother-to-child
transmission of HIV
Министерство здравоохранения
Республики Карелия
Kaliningrad
Elena Kuzmicheva

HIV incidence and prevalence in Republic of Karelia
In 2016, 175 HIV cases were diagnosed, of whom 161 among residents
of Karelia.
HIV incidence amounted to 25,5 per 100,000 population, which is by
11,5% lower than the 2015 incidence rate
From January to May 2017, 78 HIV cases were diagnosed, of whom 72
were residents of Karelia.
The incidence was 11,4 per 100,000 population, which is by 22,6% higher
than in the similar period of 2016 (9,3 per 100,000)
As of 1.6.2017, totally 1,989 HIV cases were diagnosed in Karelia, of
whom 1,662 were Karelia’s residents. The prevalence is 263,9 per
100,000 population.

HIV incidence and prevalence
incidence

HIV incidence and prevalence by municipality
• In some municipalities the HIV rates are higher than the Russian average rates (594,3 per
100,000 population as of 1.1.2017)
234,6
445,9
662,5
105,7
212,4
63,5
205,5
453,4
1094,9
139,9 123,4
313,2
263,0
215,3
103,8
158,7 168,8
204,9
263,9
594,3
0,0
200,0
400,0
600,0
800,0
1000,0
Районы республики
Республика Карелия
Российская Федерация
Municipalities
Karelia
Russia

Distribution of PLWHs by gender
• Women make up 37,3% in the total
HIV+ population 62,7%
37,3%
53,7
57,8
67,1
51,7
62,9
69,9
61,8
75,4
60,0
66,5
55,0 55,2 58,5 59,4 61,5
46,3
42,2
32,9
48,3
37,1
30,1
38,2
24,6
40,0
33,5
45,0 44,8 41,5 40,6 38,5
0 %
25 %
50 %
75 %
100 %
2003 г. 2004 г. 2005 г. 2006 г. 2007 г. 2008 г. 2009 г. 2010 г. 2011 г. 2012 г. 2013 г. 2014 г. 2015 г. 2016 г. 2017 г.
женщины
мужчины
Females
Males

Age structure of the HIV+ population
• Among all PLWHs, the share of the young population aged 20-29 years is
45,5%, and aged 30-34 years – 34,0%
0-14 лет;
0,6% 15-19 лет;
4,9%
20-29 лет;
45,5%
30-39 лет;
34,0%
40-49 лет;
10,6%
50 и старше;
4,3%

Changes in the age structure of the HIV+ population
• More HIV+ people in senior
age groups
• In 2011, aged 20-29 made
44,2%,
30-39 years – 39,5%,
40-49 years – 10,9%,
Over 50 years – 1,8%.
• In 2016,
20-29 years - 19,4%,
30-39 years – 45,7%,
40-49 years – 21,7%,
Over 50 years – 9,7%.
0,6 1,2 0,5 0,5 0,62,7 3,0 3,0
1,9 3,3 2,0 2,9
37,7
44,2 44,3
35,0
35,0 36,5
19,4
23,1
41,2
39,5 37,1
41,9 40,4 40,5
45,7
35,9
11,4
10,9
9,6
16,2 14,8 16,5
21,7
28,2
7,0
1,8 4,8 5,0 6,0 4,0
9,7 12,8
0 %
10 %
20 %
30 %
40 %
50 %
60 %
70 %
80 %
90 %
100 %
2010г. 2011г. 2012г. 2013г. 2014г. 2015г. 2016г. 2017г.
50 и старше 40-49 лет 30-39 лет 20-29 лет 15-19 лет 0-14 лет

Age structure of HIV+ women
• Women prevail over men in age groups 15-19 years, 20-29 years and over 50 years.
The leading age groups, alike with men, are 20-29 years and 30-39 years
0-14 yo;
0,3%
15-19 yo;
6,9%
20-29 yo;
46,1%
30-39 yo;
29,6%
40-49 yo;
10,8%
50 and older;
6,3%

Key transmission routes
43 %
55 %
1 %0 %
1 %
Заражение при
употреблении в/в
наркотиков
гетеросексуальных
контактах
гомосексуальных контактах
парентеральных
вмешательствах в ЛПУ
Заражение от матери во
время беременности и
родов
IDU
Heterosexual contacts
Homosexual contacts
Blood products in healthcare sector
Mother-to-child

Key transmission routes
32,7
51,3 54,3
40,6 41,4
45,1
40,8
34,1
28,6
33,3 30,3 27,8
65,5
47,4 44,7
52,2
58,6 54,0
56,9
65,1
69,4
64,2
68,0 70,4
0 %
10 %
20 %
30 %
40 %
50 %
60 %
70 %
80 %
90 %
100 %
2006 г. 2007 г. 2008 г. 2009 г. 2010 г. 2011 г. 2012 г. 2013 г. 2014 г. 2015 г. 2016 г. 2017 г.
Заражение при употреблении в/в наркотиков Заражение при гомосексуальных контактах
Заражение при гетеросексуальных контактах Заражение от матери во время беременности и родов
Заражение при парентеральных вмешательствах в ЛПУ
IDU
Heterosexual contacts
Blood products
Homosexual contacts
MTCT

Follow-up care for pregnant women and children born to HIV+
mothers
As of 01.06.2017:
Abortion – 145
Deliveries – 284, of which in 2016 – 32, in 2017 - 12.
HIV diagnosed with 11 children, of whom born in Karelia – 10 (of whom in 2014
– 1, in 2015 – 1, in 2016 – 1).
Died of HIV – 2 children, moved from Karelia – 2.
Under follow-up – 9 children (7 born in Karelia and 2 arrived from other
regions). All receive ARVT

Child deliveries among HIV+ women in Republic of Karelia
1
8
5
10
8
11
7
16
18
16
26
20
28
35
31
32
12
0
10
20
30
1999 г.2000 г.2001 г.2002 г.2003 г.2004 г.2005 г.2006 г.2007 г.2008 г.2009 г.2010 г.2011 г.2012 г. 2013г. 2014г. 2015г. 2016г. 2017г.
Absolutenumber

Coverage with chemotherapy
80,8
95,0
89,3
97,1 96,9
93,7
83,3
80,8
85,0
82,2
88,6
93,7 93,7
83,3
96,1
100,0
96,4
100,0 100,0 100,0 100
80,8
85,0
82,2
88,6
93,7
90,6
83,3
0,0
20,0
40,0
60,0
80,0
100,0
2011 2012 2013 2014 2015 2016 2017
% беременных,
получивших
ВААРТ или ХП
во время
беременности
% беременных,
получивших ХП
во время родов
%
новорожденных,
получивших ХП
% пар мать-дитя,
получвших
трехэтапную ХП
% of pregnant
women who
received ARVT or
chemotherapy
during pregnancy
% of pregnant
women who
received
chemotherapy
during pregnancy
% of newborns
who received
chemotherapy
% of mother-child
couples who
received 3-stage
chemotherapy

Summary of 2016
In 2016, out of 32 pregnant women, 30 were in follow-up in women’s clinics
and AIDS Centre (93,7%), average for Russia – 92,0%.
 Chemotherapy:
• - in pregnancy– 30 (93,7%), average for Russia – 89%,
 29 women had undetectable viral load (91,6%, average for Russia – 79%)
• - during labours – 30 (93,7%), average for Russia – 94,6%
• - to newborns – 32 (100%), average for Russia – 99%
• - 3-stage – 29 (90,6%)
 One women started receiving chemotherapy in labours, one only received
drugs during pregnancy, and one more never received chemotherapy.
 All 100% newborns received chemotherapy.
 PCR testing gave no positive results for children born in 2016

2017
In January-May 2017, 12 child deliveries and 3 abortions were recorded
10 mother-child couples received chemoprevention
In 2 cases chemoprevention was not done to women in pregnancy (refusal)
and labours
100% of children received chemoprevention
9 women had undetectable viral load
PCR was done to 11 children (in one case blood could not be taken from a
child with little weight, another attempt will be done at 2-months age),
including children whose mothers had ni chemotherapy. All results were
negative.

и социального развития Республики Карелия
Commission on MTCT prevention
 Tasks of the Commission
 Discusses and settles questions of medical care to HIV+ pregnant women,
parturients, children born to HIV+ mothers.
 Gives recommendations on managing HIV+ pregnant women, managing labours,
follow-up of newborns, monitoring of how recommendations are carried out.
 Analysis of MTCT prevention measures in pregnancy, labours, to newborns in all
child delivery outcomes among HIV+ women
 Consideration of all MTCT cases

Commission on MTCT prevention
 Regulations
 Meetings when needed, but at least once in three months
 Healthcare organisations submit (upon request of the Commission’s secretary)
medical records for HIV+ pregnant women, parturients, children born to HIV+
mothers.
 Specialists from healthcare organisations take part at the meetings of the
Commission upon invitation
 Commission’s decisions are documented in the minutes of the meeting.
 Commission’s recommendations are documented into the medical records.
 Annually, the Commission submits information about the results to the Ministry
of Health of the Republic of Karelia

Thank you for attention

HIV incidence in Republic of Karelia. Chemoprevention of mother-to-child transmission of HIV_ eng

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