XVIII International AIDS Conference

Abstract

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Increased lethality of A/H1N1 among persons living with HIV in Mexico: analysis of the first three months of the human flu epidemic

J.A. Izazola-Licea1, E. Bravo-Garcia2, M. Hernandez-Avila3

1National Center for AIDS Prevention and Control (CENSIDA), Director General, Mexico City, Mexico, 2National Center for AIDS Prevention and Control (CENSIDA), Subdirection of Epidemiological Models, Mexico City, Mexico, 3Ministry of Health-Mexico, Undersecretary for Health Promotion and Prevention, Mexico City, Mexico

Background: The A/H1N1 human flu epidemic started in April in Mexico. There is an estimate of 220,000 persons living with HIV in the country; 65,000 of these are receiving antiretroviral treatment. All with medical indication for ART have access to the drugs free of cost for the patient.
Methods: The objective was to determine the incidence and lethality of the A/H1HN1 human flu virus among persons living with HIV compared to the general population. The databases of people who had A/H1N1 human flu virus nationally and of persons living with HIV receiving antiretroviral therapy as part of the Ministry of Health were analyzed for the first three months of the epidemic in Mexico (April-July 2009).
Databases analyzed: Human Flu (n=73,257), National AIDS cases registry (N=132,455), National HIV infection registry (n=28,186), Persons receiving ART in the MoH --SALVAR-- (n=46,088), AIDS registry social Security Private sector --IMSS- (n=19,840), AIDS registry of Social Security for public employees institute --ISSSTE- (n=3,245).
Results: As of 20 July 2009, 12,662 cases of A/H1N1 infection had been reported. The A/H1N1 infection incidence was 0.109% while the incidence among people living with HIV was 0.117%. The total number of deaths due to A/H1N1 in the period was 124 people, mortality rate=0.98%. The lethality of A/H1N1 for people with HIV/AIDS receiving ARV mortality rate=5%, (one death); there were 23 additional deaths of people with HIV who were not receiving ARV (because there was no medical indication), mortality rate=8.7%.
Conclusions: The prevalence was not statistically different between the general population and the people living with HIV. The persons living with HIV receiving antiretroviral treatment, or not, are a priority population for preventive measures to avoid infection with the A/H1N1 human flu virus; focus on early diagnosis and specific treatment is a priority. The persons living with HIV are a priority for vaccination.


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