Hrvatske konsenzus konferencije o virusnim hepatitisima održane su 2005. i 2009. g. (1). S obzirom na brojne nove spoznaje o
epidemiologiji, dijagnostici i liječenju virusnih hepatitisa (poglavito kroničnog hepatitisa C genotipa 1) u protekle četiri godine, 28.
veljače 2013. g. održana je nova Hrvatska konsensus konferencija o virusnim hepatitisima u Zagrebu. Sažeti tekst ove Hrvatske
konsenzus konferencije o virusnim hepatitisima sadrži prikaz novih spoznaja o epidemiologiji virusnih hepatitisa, serološkoj i molekularnoj dijagnostici virusnih hepatitisa, određivanju polimorfizma promotora gena za IL-28, procjeni stadija fibroze, algoritmu
dijagnostičkog praćenja bolesnika, liječenju kroničnog hepatitisa C (genotipovi 1-6) i hepatitisa B, liječenju specijalnih populacija
(djeca, bolesnici na dijalizi, bolesnici liječeni transplantacijom, osobe s HIV/HCV koinfekcijom) i nuspojavama liječenja.
Adresa za dopisivanje: Prof. dr. sc. Adriana Vince, dr. med.
Zavod za virusni hepatitis
Klinika za infektivne bolesti “Dr. Fran Mihaljević”
10 000 Zagreb, Hrvatska
E-pošta: avince@bfm.hr
This dissertation examines the relationship between the rule of law and the right to development in Rwanda and South Sudan. It will define the rule of law, discuss its history and characteristics. It will also define the right to development and explore the synergy between the rule of law and the right to development. Specifically, it will analyze how the lack of rule of law in Rwanda and South Sudan has impacted development, leading to conflicts, human rights violations, poverty and infrastructure destruction. The dissertation aims to establish that upholding the rule of law is essential for promoting socio-economic development and protecting third generation rights.
Selection of Relevant Fields of Searchable Form Based on Meta Keywords Freque...AM Publications
Crawling the hidden web is a very challenging problem due to the number of active web pages on the web is
increasing exponentially. Hidden web contents are highly relevant to every information need for searching purpose. Hidden
web contents are usually behind the searchable form, ignore by all traditional crawler so hidden web crawler used for this
purpose. Because of hidden web contains a vast amount of data so it is necessary to crawl only specific hidden data. In this
paper, a meta keywords frequencies based architecture has been proposed to carry this work.
This document provides information about the short film "Gradient" including:
- The director, writers, producers and cast and crew.
- It is a 5 minute silent film produced in Edmonton, Alberta about a woman who must confront her wrongdoings.
- Biographies are included for the director Chris O'Callaghan, lead actress Siera Knight, and cinematographer Thomas Jacquard.
Hrvatske konsenzus konferencije o virusnim hepatitisima održane su 2005. i 2009. g. (1). S obzirom na brojne nove spoznaje o
epidemiologiji, dijagnostici i liječenju virusnih hepatitisa (poglavito kroničnog hepatitisa C genotipa 1) u protekle četiri godine, 28.
veljače 2013. g. održana je nova Hrvatska konsensus konferencija o virusnim hepatitisima u Zagrebu. Sažeti tekst ove Hrvatske
konsenzus konferencije o virusnim hepatitisima sadrži prikaz novih spoznaja o epidemiologiji virusnih hepatitisa, serološkoj i molekularnoj dijagnostici virusnih hepatitisa, određivanju polimorfizma promotora gena za IL-28, procjeni stadija fibroze, algoritmu
dijagnostičkog praćenja bolesnika, liječenju kroničnog hepatitisa C (genotipovi 1-6) i hepatitisa B, liječenju specijalnih populacija
(djeca, bolesnici na dijalizi, bolesnici liječeni transplantacijom, osobe s HIV/HCV koinfekcijom) i nuspojavama liječenja.
Adresa za dopisivanje: Prof. dr. sc. Adriana Vince, dr. med.
Zavod za virusni hepatitis
Klinika za infektivne bolesti “Dr. Fran Mihaljević”
10 000 Zagreb, Hrvatska
E-pošta: avince@bfm.hr
This dissertation examines the relationship between the rule of law and the right to development in Rwanda and South Sudan. It will define the rule of law, discuss its history and characteristics. It will also define the right to development and explore the synergy between the rule of law and the right to development. Specifically, it will analyze how the lack of rule of law in Rwanda and South Sudan has impacted development, leading to conflicts, human rights violations, poverty and infrastructure destruction. The dissertation aims to establish that upholding the rule of law is essential for promoting socio-economic development and protecting third generation rights.
Selection of Relevant Fields of Searchable Form Based on Meta Keywords Freque...AM Publications
Crawling the hidden web is a very challenging problem due to the number of active web pages on the web is
increasing exponentially. Hidden web contents are highly relevant to every information need for searching purpose. Hidden
web contents are usually behind the searchable form, ignore by all traditional crawler so hidden web crawler used for this
purpose. Because of hidden web contains a vast amount of data so it is necessary to crawl only specific hidden data. In this
paper, a meta keywords frequencies based architecture has been proposed to carry this work.
This document provides information about the short film "Gradient" including:
- The director, writers, producers and cast and crew.
- It is a 5 minute silent film produced in Edmonton, Alberta about a woman who must confront her wrongdoings.
- Biographies are included for the director Chris O'Callaghan, lead actress Siera Knight, and cinematographer Thomas Jacquard.
This document provides information about sexuality and relationships for young people. It discusses anatomy and puberty for both males and females. It explains body parts and their functions, as well as how to maintain good hygiene. It also covers topics like erections, wet dreams, menstruation and menstrual hygiene. The goal is to provide accurate information to help young people feel happier, healthier and more in control of their lives.
This document provides tips and information for a presentation on sleep disorders and Parkinson's disease. It begins with general presentation tips, such as using large font sizes and bullet points. It then outlines background information on sleep cycles and disorders. Several common sleep disorders are defined, with sleep apnea and REM behavior disorder discussed in further detail. Symptoms, risk factors, diagnosis, and treatment options are described for each. The presentation concludes with encouraging Q&A and activities to engage the audience.
It gives us a great pleasure to release the Second edition of Highlight. The magazine’s members have shown considerable cooperation as well as devotion. Simple and interesting articles have developed specific subjects regarding different fields. On behave of the magazine’s members; I would like to express our thanks to all who have partially contributed to the magazine.we share our knowledge as we can in providing BE.,MBA and ME projects for students.psychological counselling was given for personal and professional stress,dullness in studies to build career and successful in life.Guidance was given for competitive exams in online as well as in our center and provide books for students.paradise 2.0 is a platform to share and acquire knowledge and develop ourselves in to integrative managers
This curriculum vitae outlines the educational and professional qualifications of Arjun Vijaya. It summarizes that he completed a diploma in 3D animation in 2009 and graduated with distinction in printmaking in 2007. It also lists his various professional experiences working as a graphic designer, freelance artist, and gallery assistant from 2009 to the present. Finally, it outlines his participation in numerous art exhibitions, workshops, and extracurricular activities.
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To address the challenges of global warming resulting worldwide climate change leading to devastating calamities and posing basic threat to all living things on earth, modern day research is rightfully directed towards clean sources of green energy. Wind Power is the fastest growing environmental friendly emission free green source of energy. Effective long distance power transfer capability of the system is warranted due to locational disadvantages of availability of some Wind Power sites situated in remote areas away from load centre and even some best sites available offshore. This paper presents the study of doubly fed induction generators (DFIG) converter controllers integrated to flexible alternating current transmission system (FACTS) to improve power transfer capability of Wind farms over long distances.
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Robert J. Bies is a professor of management at Georgetown University's McDonough School of Business. He received his PhD from Stanford University in 1982. Bies has received many teaching awards and has published extensively. He has served as editor for several academic journals and books. Bies focuses his research on organizational justice, negotiation, and leadership. He has authored numerous journal articles and book chapters on these topics.
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Materials are the inputs to the construction activity. Materials forms the single largest component of the
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cost overrun. There are several method for supplier selection and it can be possible to select ideal suppliers by using of
those methods but these several traditional methods fails to collect information of all the suppliers with all their
material correctly, also it takes too much time to collect such information manually. For supplier selection purpose
requirement of all data about supplier like personal detail, cost of materials, quantity, quality, delivery services,
location, communication facility, discount, transportation facility, experience, etc. and collecting these information
would be less or no time consuming using data base. Hence GIS is very effective tool for data base management, GIS
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Then it is very easy to find out suppliers location, all detail information of suppliers, ideal suppliers and shortest route
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This document outlines the work experience of an individual with over 15 years of experience managing construction and engineering projects. They have held roles such as project manager, construction manager, contract manager, and lead engineer on a variety of commercial and industrial building projects including laboratories, offices, sports centers, and factories. Their experience spans working with companies in various sectors such as food, chemicals, engineering, and nuclear energy.
Hrvatske konsenzus konferencije o virusnim hepatitisima održane su 2005. i 2009. g. (1). S obzirom na brojne nove spoznaje o
epidemiologiji, dijagnostici i liječenju virusnih hepatitisa (poglavito kroničnog hepatitisa C genotipa 1) u protekle četiri godine, 28.
veljače 2013. g. održana je nova Hrvatska konsensus konferencija o virusnim hepatitisima u Zagrebu. Sažeti tekst ove Hrvatske
konsenzus konferencije o virusnim hepatitisima sadrži prikaz novih spoznaja o epidemiologiji virusnih hepatitisa, serološkoj i molekularnoj dijagnostici virusnih hepatitisa, određivanju polimorfizma promotora gena za IL-28, procjeni stadija fibroze, algoritmu
dijagnostičkog praćenja bolesnika, liječenju kroničnog hepatitisa C (genotipovi 1-6) i hepatitisa B, liječenju specijalnih populacija
(djeca, bolesnici na dijalizi, bolesnici liječeni transplantacijom, osobe s HIV/HCV koinfekcijom) i nuspojavama liječenja.
Adresa za dopisivanje: Prof. dr. sc. Adriana Vince, dr. med.
Zavod za virusni hepatitis
Klinika za infektivne bolesti “Dr. Fran Mihaljević”
10 000 Zagreb, Hrvatska
E-pošta: avince@bfm.hr
Association PROI is prowd to present the sixth eddition of the HHR (HIV/Harm Reduction) Bulletin for Bosnia and Herzegovina. The Bulletin was prepared by Association PROI with the support of the Global Fund to fight AIDS, Tuberculosis and Malaria, and with the support of UNDP. Materials for this issue of the Bulletin were contributed by partner organisation Association Marina, Association XY, Apoha, Action against AIDS, Partnership for Health, IOM, World Vision, Assotiation Victoria and Poenta.
The sixth eddition of the HRR Bulletin covers October, November and December 2014.
This document provides information about sexuality and relationships for young people. It discusses anatomy and puberty for both males and females. It explains body parts and their functions, as well as how to maintain good hygiene. It also covers topics like erections, wet dreams, menstruation and menstrual hygiene. The goal is to provide accurate information to help young people feel happier, healthier and more in control of their lives.
This document provides tips and information for a presentation on sleep disorders and Parkinson's disease. It begins with general presentation tips, such as using large font sizes and bullet points. It then outlines background information on sleep cycles and disorders. Several common sleep disorders are defined, with sleep apnea and REM behavior disorder discussed in further detail. Symptoms, risk factors, diagnosis, and treatment options are described for each. The presentation concludes with encouraging Q&A and activities to engage the audience.
It gives us a great pleasure to release the Second edition of Highlight. The magazine’s members have shown considerable cooperation as well as devotion. Simple and interesting articles have developed specific subjects regarding different fields. On behave of the magazine’s members; I would like to express our thanks to all who have partially contributed to the magazine.we share our knowledge as we can in providing BE.,MBA and ME projects for students.psychological counselling was given for personal and professional stress,dullness in studies to build career and successful in life.Guidance was given for competitive exams in online as well as in our center and provide books for students.paradise 2.0 is a platform to share and acquire knowledge and develop ourselves in to integrative managers
This curriculum vitae outlines the educational and professional qualifications of Arjun Vijaya. It summarizes that he completed a diploma in 3D animation in 2009 and graduated with distinction in printmaking in 2007. It also lists his various professional experiences working as a graphic designer, freelance artist, and gallery assistant from 2009 to the present. Finally, it outlines his participation in numerous art exhibitions, workshops, and extracurricular activities.
DFIG CONVERTER CONTROLLERS USED IN WIND FARMS TO IMPROVE POWER TRANSFER CAPAB...AM Publications
To address the challenges of global warming resulting worldwide climate change leading to devastating calamities and posing basic threat to all living things on earth, modern day research is rightfully directed towards clean sources of green energy. Wind Power is the fastest growing environmental friendly emission free green source of energy. Effective long distance power transfer capability of the system is warranted due to locational disadvantages of availability of some Wind Power sites situated in remote areas away from load centre and even some best sites available offshore. This paper presents the study of doubly fed induction generators (DFIG) converter controllers integrated to flexible alternating current transmission system (FACTS) to improve power transfer capability of Wind farms over long distances.
CREACIÓN DE UNA ESTACIÓN DE RADIO COMUNITARIA POR ESTUDIANTES DE LA UNIVERSID...Lisandro Galindez
Este documento presenta una propuesta para crear una estación de radio comunitaria gestionada por estudiantes de la Universidad Fermín Toro en Yaritagua, Yaracuy. El objetivo es capacitar, motivar y dar experiencia a los estudiantes en el manejo de una radio comunitaria para informar a la población local. De no aprobarse la propuesta, se retrasaría la evolución del sistema de comunicación en la zona y se violaría el derecho a la libre expresión y comunicación. El proyecto busca mejorar la comunicación, ofrecer o
Robert J. Bies is a professor of management at Georgetown University's McDonough School of Business. He received his PhD from Stanford University in 1982. Bies has received many teaching awards and has published extensively. He has served as editor for several academic journals and books. Bies focuses his research on organizational justice, negotiation, and leadership. He has authored numerous journal articles and book chapters on these topics.
GIS based material management and supplier selection in Thane city – A case s...AM Publications
Materials are the inputs to the construction activity. Materials forms the single largest component of the
total cost of the facility. Material cost being in the range of 50% to 60% of the total cost of the project. Improper
supplier selection usually faces problems in price of material, delivery, communication, quality, timely availability of
materials, etc. and its bad effect on the cost of project, so need of ideal supplier is for avoiding these problems and also
cost overrun. There are several method for supplier selection and it can be possible to select ideal suppliers by using of
those methods but these several traditional methods fails to collect information of all the suppliers with all their
material correctly, also it takes too much time to collect such information manually. For supplier selection purpose
requirement of all data about supplier like personal detail, cost of materials, quantity, quality, delivery services,
location, communication facility, discount, transportation facility, experience, etc. and collecting these information
would be less or no time consuming using data base. Hence GIS is very effective tool for data base management, GIS
should be used for storing and quantifying all data of all suppliers and using these data easily screen all suppliers in
very short time. By using GIS GRAM++ software, digitise map of study area, roads and locate location of suppliers,
Then it is very easy to find out suppliers location, all detail information of suppliers, ideal suppliers and shortest route
between supplier and construction site by developing queries in very short time.
This document outlines the work experience of an individual with over 15 years of experience managing construction and engineering projects. They have held roles such as project manager, construction manager, contract manager, and lead engineer on a variety of commercial and industrial building projects including laboratories, offices, sports centers, and factories. Their experience spans working with companies in various sectors such as food, chemicals, engineering, and nuclear energy.
Hrvatske konsenzus konferencije o virusnim hepatitisima održane su 2005. i 2009. g. (1). S obzirom na brojne nove spoznaje o
epidemiologiji, dijagnostici i liječenju virusnih hepatitisa (poglavito kroničnog hepatitisa C genotipa 1) u protekle četiri godine, 28.
veljače 2013. g. održana je nova Hrvatska konsensus konferencija o virusnim hepatitisima u Zagrebu. Sažeti tekst ove Hrvatske
konsenzus konferencije o virusnim hepatitisima sadrži prikaz novih spoznaja o epidemiologiji virusnih hepatitisa, serološkoj i molekularnoj dijagnostici virusnih hepatitisa, određivanju polimorfizma promotora gena za IL-28, procjeni stadija fibroze, algoritmu
dijagnostičkog praćenja bolesnika, liječenju kroničnog hepatitisa C (genotipovi 1-6) i hepatitisa B, liječenju specijalnih populacija
(djeca, bolesnici na dijalizi, bolesnici liječeni transplantacijom, osobe s HIV/HCV koinfekcijom) i nuspojavama liječenja.
Adresa za dopisivanje: Prof. dr. sc. Adriana Vince, dr. med.
Zavod za virusni hepatitis
Klinika za infektivne bolesti “Dr. Fran Mihaljević”
10 000 Zagreb, Hrvatska
E-pošta: avince@bfm.hr
Association PROI is prowd to present the sixth eddition of the HHR (HIV/Harm Reduction) Bulletin for Bosnia and Herzegovina. The Bulletin was prepared by Association PROI with the support of the Global Fund to fight AIDS, Tuberculosis and Malaria, and with the support of UNDP. Materials for this issue of the Bulletin were contributed by partner organisation Association Marina, Association XY, Apoha, Action against AIDS, Partnership for Health, IOM, World Vision, Assotiation Victoria and Poenta.
The sixth eddition of the HRR Bulletin covers October, November and December 2014.
Association PROI is happy to present the fifth issue of the HHR (HIV/Harm Reduction) bulletin for Bosnia and Herzegovina. It was prepared by Association PROI within the Global Fund to fight AIDS, tuberculosis and malaria, and with the support of UNDP. Contributing to the content were partner organizations, Association Margina, Association XY, Apoha, Action Against Aids, Partnership for Healht, IOM, World Vision, Association Viktorija and Poenta.
Devet komora u zdravstvu provelo je u siječnju 2021. veliko istraživanje stavova o cijepljenju protiv COVID-19 u kojem je sudjelovalo skoro 9.000 članova.
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Digitalni atlas hrvatskog liječništva je najopsežnija i najkompleksnija digitalna baza podataka o liječnicima u Hrvatskoj koja prikazuje brojne sociodemografske pokazatelje i podatke u realnom vremenu te se kontinuirano nadopunjava novim analizama i prikazima podataka.
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Zastupljenost msm populacije u sistem hiv prevencije, tretmana i njege u klinici za infektivne bolesti u sarajevu vesna hadžiosmanović
1. 1
Zastupljenost MSM populacije u sistem
HIV prevencije, tretmana i njege u Klinici
za infektivne bolesti u Sarajevu
Vesna Hadžiosmanović
Klinika za infektivne bolesti KCUS
7th
Regional HIV and AIDS
Conference
Sarajevo, 28th
-29th
May 2015
2. 2
Epidemiološka situacija u BiH
• BiH je zemlja s niskom HIV prevalencijom: <0,1%
• 2014 g.: 268 registrovanih slučajeva HIV/AIDS-a
• Registrovani slučajevi pokazuju trend rasta u posljednje 4
godine
• U 78% slučajeva su posljedica rizičnog seksualnog
ponašanja
• Putevi prenosa su: 51,4% HS; 29,4% MSM; 8,9% PWID
• HIV epidemija među PWID se stabilizovala, ali se povećala
HIV prevalencija među MSM (sa 8,9% u 2010. g. na 29,4%
u 2012. g.)
3. 3
Epidemiološka situacija
u Bosni i Hercegovini
Epidemiološki podaci za BiH, FBiH i RS za
period od 1986. do 31.12.2014. godine
BiH FBiH RS
no. % no. % no. %
Ukupno registrirane HIV+ osobe
*u BiH je evidentirano još 10 nedeterminisanih prijeratnih HIV+
osoba (7 muškarca i 3 žene)
258
(+10)* = [268]
165 93
Nema podataka 3 1,22
Od toga AIDS 104 51,42 84 50,90 20
Spol
Muškarci 211 80 137 82,82 74
Žene 46 18,77 28 17,18 18
Put prenosa
HIV infekcije
Heterosexualni odnos 125 51,42 84 50,90 20
Homosex./Bisex. odnos 93 29,38 62 37,57 31
I.V. upotreba narkotika 20 8,97 15 9,09 5
Krv i preparati krvi 3 1,22 1 0,6 2
Vertikalna transmisija 2 0,81 1 0,6 1
Neidentificirani put 18 6,93 6 3,6 9
4. 4
Epidemiološka situacija u KCUS
• U KCUS broj HIV slučajeva u HS populaciji je rapidno
opadao dok je u MSM populaciji rastao u proteklih 5 godina.
• U petogodišnjem razdoblju, 69,8% novodijagnosticiranih
HIV slučajeva su bili posljedica seksualnih kontakata među
MSM.
• Između 2010. i 2014. godine, MSM su bili jedina grupa u
kojoj je godišnji broj novih HIV dijagnoza bio povećan.
• HIV testiranje u VCCT je bilo ključno u HIV/AIDS strategiji
prevencije.
5. 5
• Analizirali smo rezultate testiranja na HIV u VCCT centru
KCUS u petogodišnjem periodu, te na osnovu toga smo
determinisali da su se navike HIV testiranja promijenile od
2010. do 2014. godine među pripadnicima MSM populacije.
6. 6
• Retrospektivno smo analizirali testiranih 6440 klijenata u
VCCT KCUS u petogodišnjem periodu od 2010. do 2014.
godine.
8. 8
Od ukupno 112 slučajeva, njih 56% je
otkriveno od 2010. do danas, u poređenju
sa 44% slučajeva do 2009. godine.
9. 9
Polna struktura u dva perioda se
statistički značajno ne razlikuje (p=0,276);
u oba perioda dominiraju muškarci
40/49 (82%) i 56/63 (89%)
10. 10
2010- maj 2015 god1992-2009 god
period
70,0
60,0
50,0
40,0
30,0
20,0
10,0
0
Starosnadob
34 (28-41)33 (26-45)
Razlike u prosjeku starosne dobi kada su otkriveni kao
HIV/AIDS između dva perioda nisu statistički značajne
(p=0,934); životne dobi su ujednačene.
o U prvom periodu do 2009. prosjek godina iznosio je 33 (26-45)
godine; najmlađi je imao 4, a najstariji 62 godine.
o U drugom periodu 2010-2015, prosjek godina pri dijagnosticiranju
HIV/AIDS-a iznosio je 34 (28-41) godine; najmlađi ispitanik imao je 21,
a najstariji 63 godine.
11. 11
Put prenosa infekcije u odnosu na
dva posmatrana perioda
o Postoji statistički značajna korelacija u putu prenosa infekcije i perioda posmatranja
ispitanika (p=0,002).
o U prvom periodu dominira 63% heteroseksulani prenos, potom slijedi
homoseksulano/biseksualni sa 20,4% i na trećem mjestu injekcioni 14%, te jedan
pojedinačan slučaj vertikalnog prenosa
o U drugom periodu od 2010. do danas dominira 71,4% homoseksulano/biseksualni
prenos, potom heteroseksulani sa 26,9%, te jedan slučaj injekcionog prenosa.
12. 12
Nema statistički značajne promjene (p=0,584) u
komparaciji otkrivenih ispitanika po kantonima;
U oba perioda dominira Kanton Sarajevo,
potom ZeDo i SB kanton, itd.
13. 13
Godina Testiranih Muškarci MSM HIV+
2010 1172 557 139 6
2011 932 521 92 6
2012 991 603 192 11
2013 1400 826 234 9
2014 1945 1235 501 12
Ukupno 6440 3742 1158 44
Testirani u VCCT centru
u periodu 2010. - 2015.
14. 14
Broj testiranih
u periodu 2010. – 2014.
Od 2010. do 2015. broj testiranih statistički
značajno raste (p=0,03)
15. 15
Postotak učešća MSM populacije u odnosu na ukupan
broj testiranih i HIV+ MSM od 2010. do 2014. godine
o 2010. god. Svaki 4 testirani(25%) muškarac bio je MSM, a 4 od 100 MSM su HIV+.
o 2011. god. Svaki 6 testirani (17%) muškarac bio je MSM, a 7 od 100 MSM su HIV+.
o 2012. god. Skoro svaki treći (32%) testirani muškarac bio je MSM, a 6 od 100 MSM su
HIV+.
o 2013. god. Skoro svaki treći (28%) testirani muškarac bio je MSM, a 4 od 100 MSM su
HIV+.
o 2014. god. Skoro svaki drugi (41%) testirani muškarac bio je MSM, a 2 od 100 MSM su
HIV+.
16. 16
2010-2014 god, udio HIV+ u odnosu na oboljele od
AIDS-a se statistički značajno razlikuje (p=0,02)
Dominiraju HIV+ sa 70%, u odnosu na
oboljele od AIDS sa 30%.
17. 17
Terapija Total
Ne Da
Infekcija/bolest
HIV
br 20 24 44
% 45,5% 54,5% 100,0%
AIDS
br 0 19 19
% 0% 100,0% 100,0%
Total br 20 43 63
% 31,7% 68,3% 100,0%
Terapija u odnosu na status HIV/AIDS
o 54,5% HIV+ ispitanika su na terapiji
o Svih 19 AIDS-oboljelih (100%) su na ARV terapiji
19. 19
Razlike u preživljavanju između HIV+ i AIDS
slučajeva su statistički značajne (p=0,0001)
60,0050,0040,0030,0020,0010,000,00
Mjeseci
1,0
0,8
0,6
0,4
0,2
0,0
Cumpreživljavanje
HIV-censored
AIDS-censored
HIV
AIDS
hiv..aids
Preživljavanje
o Svi HIV+ su
preživjeli (100%),
nema smrtnih
slučajeva.
o 74% Ispitanika
sa AIDS-om je
preživjelo, 5
(26%) nije
preživjelo, a svi
su umrli unutar
11 mjeseci od
dijagnosticiranja
HIV-bolesti
22. 22
• U posljednjih 5 godina rezultati testiranja na HIV provedeni
Klinici za infektivne bolesti u KCUS su pokazali porast broja
HIV/AIDS slučajeva u MSM populaciji, iako je HS način
transmisije HIV infekcije od početka epidemije do tada igrao
glavnu ulogu.
23. 23
Rezultati
• Evidentira se povećanje testiranih sa 36,5% u 2010. god.
na 56,2% u 2014 god; sa 63% na 71% među MSM
• Od svih novodijagnosticiranih muškaraca sa HIV-om, njih
80,3% su bili MSM (n=56)
• Starosna dob osoba koje žive s HIV/AIDS-om u prosjeku je
35 godina.
• Starosna dob u vrijeme smrti u prosjeku oko 44 godina.
24. 24
o Od ukupno 1158 MSM
testiranih klijenata, njih 44
(3,79%) su bili HIV-
novodijagnosticirani
o Od 44 osobe koje su bile
HIV-novodijagnosticirani
MSM, njih 26 (59,09%) su na
anti-HIV tretmanu (svi imaju
nedetektibilan viral load)
MSM HIV-dijagnosticirani,
na tretmanu i sa VL statusom
25. 25
Rezultati
• Od 44 novodijagnosticiranih MSM u posljednjih 5 godina
njih 30% su dijagnosticirani u kasnom stadiju bolesti.
• Nedijagnosticirani i kasno dijagnosticirani HIV su i nadalje
veliki problem.
• 5 od 63 osobe s HIV/AIDS-om su umrle;
svi su bili dijagnosticirani u kasnom stadiju bolesti.
26. 26
Zašto je prevencija važna?
• Jedna prevenirana HIV infekcija ima pozitivne efekte na :
javno zdravstvo – velike uštede;
kvalitet života osoba s HIV-om.
• Većina novih transmisija su akvirirane od osoba koje nisu
HIV-dijagnosticirane.
• 30% od svih novodijagnosticiranih su definisani kao kasni
prezenteri, što dovodi do većih troškova za tretman
komorbiditeta, medicinske njege i dr
• Osobe koje se dijagnosticiraju kasnije su pod većim
rizikom od morbiditeta i mortaliteta.
27. 27
Zašto je prevencija važna?
• Nove HIV infekcije su posljedica transmisije sa osoba koje
nisu dijagnosticirane, tako da je naglašena potreba za
povećanim HIV testiranjem.
• Neophodno je posvetiti pažnju savjetovanju.
• Tretman kao preventivna mjera može funkcionirati samo
ako su inficirane osobe dijagnosticirane ranije i ako su
efikasno tretirane.
28. 28
Zašto je prevencija važna?
• Efikasan HIV tretman reducira VL, reducira dalju transmisiju
i pravi uštede koje prate kasnije dijagnosticiranje.
• Kontinuirana upotreba kondoma, čak i u vrijeme kada je
ART uključen.
• Obezbijediti strateški plan: testiranje, tretman (kao
prevencija), promjena ponašanja (informacije, približiti se
klijentima, savjetovanje, program kondoma).
29. 29
Šta smo uradili?
• 2013. I Evropska sedmica testiranja na HIV
Testirana 82 klijenta, 33 MSM
30. 30
• 2014. II Evropska sedmica testiranja na HIV
Šta smo uradili?
Testirana 103 klijenta, 32 MSM
31. 31
Šta smo uradili?
• Obilježavanje svjetskog sana hepatitisa
• Obilježavanja 1.decembra svjetskog dana borbe protiv
HIV/AIDS-a
Kampanje su bile fokusirane na podizanje svijesti o HIV-u i AIDS-u i
istovremenoj borbi protiv stigme, dajući support osobama koje se
žele testirati ili osobama koje žive s HIV-om.
Testirano 163 klijenata, 78 MSM
Outreach: 661 testiranih 2013.-2014.
32. 32
• Veliki broj MSM imaju povećanu šansu da budu eksponirani
na HIV.
• Stigma i diskriminacija ograničava pristup njezi, inhibira
dolazak MSM populacije u VCCT, reducira mogućnost
otkrivanja statusa osoba pod rizikom, što treba promijeniti
kako bi se poboljšao odgovor na HIV u zdravstvenom
sistemu.
33. 33
Zaključci
• Iako su nalazi o povećanom HIV testiranju ohrabrujući,
potrebno je poboljšati pokrivenost sistemom HIV testiranja
kako bi se zadovoljile preporuke CDC.
• HIV testiranje je ključno u strategiji prevencije AIDS-a, s
obzirom da rano dijagnosticiranje i rano uvođenje tretmana
koristi i inficiranim osobama i javnom zdravstvu općenito u
smislu nadzora nad epidemijom.
• Dizajnirati programe koji imaju za cilj povećanje broja
testiranih u populacijama pod visokim rizikom od HIV
infekcije.
• Netestirani MSM bi mogli igrati dramatičnu ulogu u širenju
HIV infekcije.
34. 34
Zaključci
Aktuelne intervencije trebaju biti fokusirane na:
Povećanom broju testiranja i savjetovanja;
Povećanom pristupu tretmanu;
Postizanju i održavanju nedetektibilnog VL;
Intenziviranju napora u prevenciji koji su fokusirani na
upotrebi kondoma.