Fewer and fewer Portuguese people have HIV and AIDS in Portugal

María Moreira Rato with Felipe Aguiar

On this World AIDS Day, it is important to mention that the National Institute of Health Dr. Ricardo Jorge (INSA) and the Directorate General of Health (DGS) released, on Tuesday, the “Report on HIV infection in Portugal – 2022” – a document on the status of HIV infection HIV and acquired immunodeficiency syndrome (AIDS) in Portugal.

According to the data collected as of October 31, 2022, 1,803 new HIV cases were diagnosed in the 2020-2021 biennium, of which 870 were new cases in 2020 and 933 in 2021, with the majority recorded in individuals older or older. Equivalent to 15 years. This data reveals a 44% decrease in the number of new HIV cases and a 66% decrease in new AIDS cases between 2012 and 2021.

Although there was a decline in numbers, the majority (71.8%) of new cases of infection in adolescents and adults aged 15 years and over were recorded in men (representing 2.5 cases per case in women) and the median age at diagnosis was 39 years. Sexual transmission occurred in 91.9% of cases in the 2020-2021 biennium, with heterosexual transmission most common (51.8%) and 40.2% among men who have sex with men (MSM). IDU cases accounted for 2.3% of the total.

In the period under review, 4 cases of HIV infection were reported in children, two of them in 2020 and the other two in the last year. It is known that as of December 31, 2021, 633 cases of HIV infection in children under 15 years of age have been diagnosed and reported in Portugal. These cases are evenly distributed between sexes and the highest incidence of diagnosis occurred in the first year of life, with mother-to-child transmission being the most frequently reported mode of transmission. It is also important to highlight that 92.6% of these cases were diagnosed more than a decade ago and that the measures implemented in Portugal to prevent mother-to-child transmission led to a decrease in new cases in children.

During 2020 and 2021, 415 new cases of AIDS were diagnosed, 202 in 2020 and 213 in 2021, all also in adolescents or adults aged 15 or older. Of the total, 291 new cases were recorded among men and 124 among women. Most new AIDS cases recorded in 2020 and 2021 (58.3%) were in individuals born in Portugal, which was observed in both sexes, and the distribution of new AIDS cases in sexually infected individuals occurred between both sexes.

Mortality in patients infected with HIV According to the data, 298 deaths were reported among HIV-infected patients that occurred in the biennium 2020-2021, of which 139 (46.6%) were in the AIDS stage. The deaths occurred predominantly in men (72.1%; 215) and the mean age at death was 58 years. As noted in previous years, IDUs had the lowest average age, 49 years at the time of death.

The time between HIV diagnosis and death was greater than 20 years in 24.5% of deaths that occurred between 2020 and 2021. On the other hand, 19.8% of deaths occurred in the first year after diagnosis and in this stratification by mode of transmission Infection revealed that the highest percentage (36.4%) of deaths in the first year after diagnosis occurred in men who had sex with men. It has also been shown that 49.3% of deaths recorded in IDU cases had the diagnosis occurring more than 20 years ago.

From 1983 to 31 December 2021, 64,257 cases of HIV infection were cumulatively diagnosed in Portugal, of which 23,399 reached the stage of AIDS and resulted in 15,555 deaths.

After verifying the first cases of HIV infection in the country, which occurred in 1983, the highest annual number of new diagnoses was reached in 1999, at 3,351. Since then, there has been a steady decline in the annual number of new cases, which were found to be 43% between diagnoses that occurred in 2000 and 2011 and 48% compared to 2012 and 2021. Last year, a higher number of diagnoses was also observed compared to With those reported for 2020, this situation may relate to the impact of the COVID-19 pandemic, and it is not yet clear whether the decline is due to limitations in accessing an HIV diagnosis, changes in behavior or other factors that have not yet been identified.

The annual report also revealed that in 2021, the number of people with access to ART increased, increasing by 5.22% and reaching 28.7 million people treated. By region, eastern and southern Africa account for nearly half of the world’s total AIDS cases: 20.6 million of them receive antiretroviral therapy. This treatment is much less common in North Africa and Central Asia, where only half of the affected population receives the necessary treatments.

It should be noted that the pandemic left Portugal without data. At the beginning of the year, it was known that three years ago, 778 new cases of HIV were diagnosed in Portugal, which corresponds to 7.6 cases / 100,000 inhabitants, “not adjusted due to delays in notification,” INSA alerted on its official website. There were 172 new cases of AIDS and 197 deaths reported in 2019 in cases of HIV infection or AIDS.

“A total of 61,433 cases of HIV infection were recorded, of which 22,835 were in the AIDS stage, where the diagnosis was made between 1983 and the end of 2019. In the same period, 15,213 deaths were reported in cases of HIV infection,” it was known. , that the numbers are now a little different, as you can see above.

It should be remembered that in February of this year, an HIV-infected North American woman was supposedly cured of HIV through a transfusion of umbilical cord blood from a child, partially compatible, with genetic resistance to the virus. . In this case, doctors did not resort to the usual bone marrow transplant from a donor of the same race. Considering that most of the donors are of Caucasian origin, this treatment opens up opportunities for many carriers of the virus.

In 2008, the first HIV-positive patient, who lived virus-free for 12 years until he died of cancer two years earlier, was cured: Timothy Ray Brown—the “Berlin patient”—who had HIV and leukemia. In 2019, Adam Castillejo – a “patient from London” – was treated and the two received stem cells from compatible donors just like the woman – a “patient from New York” – who suffers from HIV and acute myelogenous leukemia. Doctors Koen van Besien, Jingmei Hsu, and Marshall Glesby of New York-Presbyterian Weill Cornell Medical Center were responsible for treating this patient.

Nearly 650,000 people died of AIDS last year, and one and a half million people were infected with the Human Immunodeficiency Virus (HIV) in the same year, the annual report of the United Nations Program on AIDS (UNAIDS) announced on Tuesday.

The report indicates that the total number of new infections last year was similar to what was recorded in 2020, while deaths decreased by 5.79%. However, the death rate was seen as particularly alarming among children: UNAIDS data indicated that 15% of all deaths last year occurred among children under 14, although They represent less than 15% of people living with HIV in the world.

According to the statistics, there are 38.4 million people living with HIV – up 1.5% from 2020, when the disease affected about 37.8 million people. Despite this, new infections have fallen by more than half (54%) since the disease peaked in 1996, while deaths have fallen 32% since 2004 – the year two million people lost their lives to AIDS.

The UN document also highlights the problem of gender inequality in the fight against AIDS in different regions of the world, particularly its impact on women living in sub-Saharan Africa, where adolescents between the ages of 15 and 19 are twice as likely to be infected. . men in the same age group. About 63% of new HIV infections in the region were women, nearly a 10% increase in global statistics.