PRESS RELEASE

1 in 2 people living with HIV in Europe is diagnosed late:
ECDC and WHO urge improvement in testing practices

Copenhagen/Stockholm, 28 November 2017

The WHO European Region is the only Region worldwide where the number of new HIV infections is rising. With more than 160 000 people newly diagnosed with HIV across the Region, including more than 29 000 new cases from the European Union and European Economic Area (EU/EEA), this trend continued in 2016. One reason for this worrying trend: over half (51%) of the reported HIV diagnoses happen in a late stage of infection.

Asked about EU action to address early testing, European Health Commissioner, Vytenis Andriukaitis, said "To meet our goal of ending HIV, we need to ensure early diagnosis for everybody, reaching out to risk groups and to the most vulnerable. To succeed, we must work together across borders, across silos, across organisations to promote easy access to diagnosis and to fight barriers such as stigma and discrimination. European Union initiatives such as the Joint Action on HIV are vital in addressing gaps in the prevention of HIV and co-infections tuberculosis and viral hepatitis among hard-to-reach groups. Next year I intend to present an overview of policies and best practices in fighting HIV - including prevention and early testing – and encourage all Member States and stakeholders to put them in practice.”[i]

ECDC Director Dr Andrea Ammon
highlights: “Our data show that Europe needs to do more in its HIV response, with more than 29 000 newly reported HIV infections in the EU/EEA each year. On average, it takes a person about three years from the time of infection until they are diagnosed - which is far too long. This results in poorer long term health outcomes for the many people that are diagnosed late and also increases the risk for onward HIV transmission. Two-thirds, that's 68%, of the new AIDS diagnoses in the EU/EEA happened only within three months after the HIV diagnosis, which indicates that these people have had the infection for many years previously.”

“The HIV epidemic continues to rise at an alarming pace in the European Region, mostly in its eastern part, which is home to almost 80% of the 160 000 new HIV diagnoses. This is the highest number of new cases ever recorded in one year. If this trend persists, we will not be able to achieve the Sustainable Development Goal target of ending the HIV epidemic by 2030,” warns Dr Zsuzsanna Jakab, WHO Regional Director for Europe. “Testing people late, particularly those at higher risk of infection, results in late treatment and further contributes to the ongoing spread of HIV. The later people are diagnosed, the more likely they are to develop AIDS, thus leading to more suffering and death. On World AIDS Day, I urge all countries to take action now to reverse the HIV epidemic in Europe.”

People over 50: two thirds diagnosed late

The HIV/AIDS surveillance data for 2016, published today by ECDC and the WHO Regional Office for Europe, show that the proportion of those who are diagnosed late is increasing with age. Across the whole Region, 65% (EU/EEA: 63%) of people aged 50 and older were diagnosed late in the course of their HIV infection.

Especially in this older age group, healthcare services in the community play a vital role in providing opportunities for earlier HIV diagnosis. HIV testing based on specific health conditions, such as other sexually transmitted infections, viral hepatitis, tuberculosis or certain cancers, could also lead to improved diagnosis.[ii]

Early diagnosis: higher life expectancy and less transmission
The WHO Regional Office and ECDC directors stress that to reduce the number of future HIV infections, Europe needs to focus on three main areas:

  1. prioritising effective and comprehensive prevention measures such as awareness-raising; promotion of safe sex, condoms and substitution therapy, provision of needle exchange programmes and pre-exposure prophylaxis for HIV;
  2. providing efficient HIV counselling and testing services, including rapid diagnostic services, community-based HIV testing and HIV self-testing; and
  3. ensuring rapid access to quality treatment and care for those diagnosed.

Early diagnosis is important because it allows people to start HIV treatment sooner, which in turn increases their chances of living a long and healthy life. In addition, it reduces the risk of:

  • transmitting HIV further, as effective treatment results in an undetectable viral load, i.e. the virus can no longer be transmitted to others;
  • developing AIDS, as considering AIDS cases having nearly doubled in the eastern part of the Region during the last decade; and
  • contracting or developing tuberculosis, the most common AIDS-defining illness in the Region, particularly in its eastern part.

Guidance to improve testing in Europe
The WHO consolidated guidelines on HIV testing services are aimed at HIV programme managers, health workers and other stakeholders to support them to increase access to HIV counselling and testing. In particular, they advocate for the introduction of self-testing and/or for the offer of counselling and testing by trained community care providers to increase uptake. Supplemented by guidance on HIV self-testing and partner notification, these guidelines support countries progressing towards the global, regional and national target that 90% of people with HIV are diagnosed by 2020.

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Notes to the editor

Late diagnosis is defined as having a CD4 cell count below 350 cells/mm3 blood at the time of diagnosis. This is a measure of the person’s immune system functioning.

The WHO European Region comprises 53 countries, with a population of nearly 900 million people, of which around 508 million live in the EU/EEA (28 EU Member States plus Iceland, Liechtenstein and Norway).

World AIDS Day was introduced by the World Health Organization (WHO) in 1988 and is observed annually on 1 December to raise awareness of the AIDS pandemic caused by HIV infection.

HIV/AIDS: The human immunodeficiency virus (HIV) is a virus, which attacks the immune system and causes a lifelong severe illness with a long incubation period. The end-stage of the untreated infection, acquired immunodeficiency syndrome (AIDS), results from the destruction of the immune system. AIDS is defined by the presence of one or more “opportunistic” illnesses (other illnesses due to decreased immunity).

 

ECDC Resources

ECDC-WHO HIV/AIDS surveillance in Europe 2017 (2016 data) https://ecdc.europa.eu/en/publications-data/hivaids-surveillance-europe-2017-2016-data

World AIDS Day 2017: https://ecdc.europa.eu/en/news-events/world-aids-day-2017  

Monitoring the Dublin Declaration: 2016 progress reports: https://ecdc.europa.eu/en/infectious-diseases-public-health/hiv-infection-and-aids/surveillance-and-disease-data/monitoring-1

ECDC Guidance: Antenatal screening for HIV, hepatitis B, syphilis and rubella susceptibility in the EU/EEA http://bit.ly/ANSguide

Calculate HIV incidence in a given population: the ECDC HIV modelling tool http://bit.ly/HIVmodel

 

WHO resources

HIV/AIDS website http://www.euro.who.int/en/health-topics/communicable-diseases/hivaids

European HIV-Hepatitis Testing Week 2017: tackling late diagnosis http://www.euro.who.int/en/health-topics/communicable-diseases/hivaids/news/news/2017/11/european-hiv-hepatitis-testing-week-2017-tackling-late-diagnosis

World AIDS Day http://www.who.int/life-course/news/events/2017-world-aids-day/en/

Statement on HIV testing services http://www.who.int/hiv/topics/vct/hts-new-opportunities/en/index1.html

Consolidated guidelines on HIV testing services http://www.who.int/hiv/pub/guidelines/hiv-testing-services/en/

Guidelines on HIV self-testing and partner notification http://www.who.int/hiv/pub/vct/hiv-self-testing-guidelines/en/

Quality of HIV testing and prevention of misdiagnosis http://www.who.int/hiv/mediacentre/news/hiv-misdiagnosis-qa/en/

 

 

Contacts

European Centre for Disease Prevention and Control (ECDC)

 

Tel. +46 858 60 16 78

Fax +46 858 60 10 01

www.ecdc.europa.eu

 

Press office

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World Health Organization, Regional Office for Europe

Cristiana Salvi

Tel. +45 45 33 6837

Fax +45 45 33 70 01

www.euro.who.int

 

Press office

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[i] About HA-REACT: http://www.hareact.eu/en/about-ha-react

[ii] See also: New HIV diagnoses among adults aged 50 years or older in 31 European countries, 2004–15: an analysis of surveillance data. http://www.thelancet.com/journals/lanhiv/article/PIIS2352-3018(17)30155-8/fulltext