Estonia at the Threshold of the Fourth Decade of the AIDS Era in Europe

Laisaar, Kaja-Triin; Avi, Radko; DeHovitz, Jack; Uusküla, Anneli

doi:10.1089/aid.2010.0223

Cited by 26 publications

(28 citation statements)

References 32 publications

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“…The number of HIV infections among men reported to be heterosexual in countries of WHO European Region East (this includes the following countries: Armenia, Azerbaijan, Belarus, Estonia, Georgia, Kazakhstan, Kyrgystan, Latvia, Lithuania, Moldova, Tajikistan, Ukraine) excluding Ukraine increased from 550 cases in 2005 to 1621 cases in 2011, while the number of HIV cases that are MSM increased from only 37 in 2005 to 120 in 2011 [7]. The pattern of reporting high percentages of heterosexual cases among men can be found in several countries in Eastern Europe, such as Georgia, Armenia, Azerbaijan and Estonia [8][9][10]. Potential underreporting of cases among MSM could be due to stigma and resulting in patients' reluctance to declare themselves as MSM [11].…”

Section: Discussionmentioning

confidence: 99%

Misclassification of Men with Reported HIV Infection in Ukraine

et al. 2015

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We analyzed data on reported mode of transmission in case reports of HIV-infections among men in Ukraine. The number of men who were reported to have acquired HIV through heterosexual transmission increased substantially in 2006-2011. However, we estimate that up to 40 % of reported cases of heterosexual transmission among men may actually represent misclassified men who have sex with men or persons who inject drugs. These findings indicate a need to improve the quality of data on reported mode of HIV transmission. Accurate information has important public health implications in planning prevention and treatment services.

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Section: Discussionmentioning

confidence: 99%

Misclassification of Men with Reported HIV Infection in Ukraine

et al. 2015

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“…Similar to other Eastern European PWID groups, the intravenous drug user (IDU) population in Estonia has high rate of HIV, HBV, and or HCV coinfections and a high percentage of opioid users (14,15,29,31). We have shown that HIV exposure increases CD45RA + RO + T cell percentages and immune activation among an Estonian PWID population (14); however, how the seropositivity of individuals with all three infections (HIV, HBV, and HCV) affects T cell distribution has thus far been seldom studied.…”

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confidence: 99%

T Cell Distribution in Relation to HIV/HBV/HCV Coinfections and Intravenous Drug Use

et al. 2016

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Intravenous drug use (IDU) is one of the most important transmission routes for blood borne viruses, including human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV). These infections alter the subset distributions of T cells; however, knowledge of such effects during HIV, HBV, and or HCV coinfection is limited. Therefore, we aimed to evaluate any associations between T cell distribution and the presence of HIV, HBV, and HCV coinfections among persons who inject drugs (PWID). Blood samples from 88 Caucasian PWID (mean age 30; 82% male) and 47 age-matched subjects negative for all three infections (mean age of 29; 83% male) were analyzed. The T cell markers CD3, CD4, CD8, CD45RA, CCR7, HLA-DR, and CCR5 were assessed using flow cytometry. Of the PWID, 40% were HIV+HBV+HCV+, 20% HBV+HCV+, 19% HCV+, and 13% negative for all three infections. The HIV+HBV+HCV+ PWID had lower percentages of CD4 + and higher percentages of CD8 + cells compared to triple negative PWID ( p < 0.001 in all cases). The only difference between HBV+HCV+ with triple negative PWID was the lower CD4 + cell percentages among the former (52.1% and 58.6%, p = 0.021). Triple negative PWID had higher immune activation and number of CCR5+ cells compared to the controls. We suggest that the altered T cell subset distribution among PWID is mainly triggered by HIV infection and or IDU, while HBV and or HCV seropositivity has minimal additional effects on CD4 + cell distribution.

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“…Th e main HIV transmission routes in Latvia are heterosexual contacts (40%) and IVDU (25%), but in 35% of cases the route of transmission is not reported [18,37]. In Lithuania and Estonia, the situation is similar [5,10,20]. Practitioners, radiologists and pathologists in the 21 st century -35 years aft er the year 1982 when WHO accepted the word "AIDS" -are diagnosing very diff erent lung diseases in HIV-infected persons.…”

Section: Introductionmentioning

confidence: 99%

“…Streptococcus pneumoniae and Haemophilus infl uenzae are predominating. Staphylococcus aureus and Pseudomonas aeruginosa are more frequent than in the general population [14,16,20].…”

Section: Introductionmentioning

confidence: 99%

Multiform spectrum of pulmonary disease in lethal HIV infection cases in Latvia (2012–2016)

Kleina

Fjodorova

Dabužinskienė

et al. 2017

PoA

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In 2016, the proportion of HIV-infected persons in the Baltic countries was as follows: Latvia 18.5, Estonia 17.4, Lithuania 7.4 per 100,000 of population. The aim of our study was to evaluate the spectrum and morphology of combined lung pathologies in fatal HIV/AIDS cases in Latvia from 2010 to 2016. We did a retrospective review of the HIV/AIDS patients' medical autopsy case files and histological slides at the Pathology Centre of Riga Eastern Clinical University Hospital. All statistical data were processed in IBM SPSS Statistics 23. We analysed 455 cases -311 (69%) men, 134 (31%) women. The mean age of the analysed patients was 40 years (±9 SD, range 22-68). The conditions leading to death were opportunistic infections (OI) -28%, tuberculosis (TB) -23%, wasting syndrome complicated by nonspecific pneumonia and sepsis or HIV/AIDS unrelated conditions -27%, malignancies -11% (B large cell lymphoma, primary and secondary cancers of the lung, Kaposi sarcoma), and end stage liver disease -11%. Lungs were affected in 380 cases (83.5%). We identified 112 cases of tuberculosis (TB). In 21%, it was isolated pulmonary TB, in 79% -disseminated TB. Additionally, OI were proved in 26% of these patients. The prevalence of OI was higher in patients who died from isolated pulmonary TB. We also identified 10 cases of disseminated atypical mycobacteriosis. Opportunistic infections were diagnosed in 126 persons -77% (n=97) of them had one, but 23% (n=29) had two or more OIs. The most common isolated OI with lung involvement was https://doi.org/10.12697/poa.2017.26.2.06Papers on Anthropology XXVI/2, 2017, pp. 53-67 54 | R. Kleina, O. Fjodorova, A. Dabužinskienė, J. Nazarovs, O. Mahmajeva Pneumocystis jiroveci (PC) pneumonia (n=71, 15.6%); 10% had cryptococcosis, 1% -pulmonary aspergillosis and Candida pneumonia each. 40 patients (9%) had disseminated cytomegalovirus (CMV). Among the various combinations of oppor tunistic infections, the most common was PC+CMV. 81% of HIV patients were unemployed and prisoners with interrupted treatment. We concluded that our study revealed that combined opportunistic infections and TB were the most frequently observed pulmonary infections, followed by primary and secondary lung malignancies and bacterial pneumonia in HIV/ AIDS unrelated cases of multiorgan disease. Diagnostic difficulties occurred mainly in disseminated diseases due to nonspecific clinical presentation, similar appearance on imaging studies and limited bacterial diagnostic possibilities after death.

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Estonia at the Threshold of the Fourth Decade of the AIDS Era in Europe

Cited by 26 publications

References 32 publications

Misclassification of Men with Reported HIV Infection in Ukraine

Misclassification of Men with Reported HIV Infection in Ukraine

T Cell Distribution in Relation to HIV/HBV/HCV Coinfections and Intravenous Drug Use

Multiform spectrum of pulmonary disease in lethal HIV infection cases in Latvia (2012–2016)

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