Features of HIV-infection in St-Petersburg

HIV/AIDS epidemic is a great challenge to the health care system. The incidence of new HIV infections in the Russian Federation is among the highest in the world. Over the past decade, the number of officially registered HIV-infected persons in St. Petersburg has exceeded 30,000 people. At present, there is a shift from the IDU to the sexual route of HIV acquisition; the frequency of sexual HIV acquisition has doubled. Among the HIV-infected people those below 30 years of age predominate (57-62%); however, we also observe an increase in the incidence of HIV infection among people over 30 while the incidence of HIV infection among younger population decreases. Beginning from 2002, the detection rate of HIV infection in pregnant women and the number of children born to HIV-infected mothers has been persistently increasing. In St. Petersburg the rate of mother-to-child HIV transmission remains high (6.7%). Over the last years, there is an increase in the number of patients with advanced stages of HiV (4A, 4B, 4C).The statistical data analysis revealed that the leading opportunistic infections are mycobacterial infection, candidiasis and Pneumocystis pneumonia (PCP). The number of people infected with both HIV and tuberculosis increases 1.5 times every year.The mortality analysis showed the persistent increase in the mortality rate among patients in the AIDS stage (from 14.2% in 2004 to 41.0% in 2008). This observation is related both to the improvement of HIV detection and increase in HIV disease severity.