       Document 0745
 DOCN  M9490745
 TI    The changing spectrum of AIDS index diseases in Canada.
 DT    9411
 AU    Montaner JS; Le T; Hogg R; Ricketts M; Sutherland D; Strathdee SA;
       O'Shaughnessy M; Schechter MT; British Columbia Centre for Excellence in
       HIV/AIDS, St Paul's; Hospital, Vancouver, Canada.
 SO    AIDS. 1994 May;8(5):693-6. Unique Identifier : AIDSLINE MED/94338608
 AB    OBJECTIVE: To describe the changing spectrum of AIDS index diseases in
       Canada over a 10-year period from 1981 to 1991. DESIGN: A descriptive,
       population-based study. SETTING: Canada. PATIENTS: All cases of AIDS in
       Canada reported by the Division of HIV/AIDS Epidemiology of the
       Department of National Health and Welfare. MAIN OUTCOME MEASURES:
       Age-standardized rates of initial AIDS manifestations (1987 Centers for
       Disease Control and Prevention case definition), by year of diagnosis
       among adults in Canada. RESULTS: A total of 6641 adult AIDS cases were
       examined. The rate of Pneumocystis carinii pneumonia (PCP) peaked in
       1989 with a rate of 3.18 per 100,000, declining to 2.74 per 100,000 in
       1991 (P = 0.894). Similarly, the rate of Kaposi's sarcoma (KS)
       stabilized during this interval from 1.06 per 100,000 in 1987 to 1.14
       per 100,000 in 1991 (P = 0.189). In contrast, the rates of all other
       AIDS-defining illnesses increased from 1.48 per 100,000 in 1987 to 3.43
       per 100,000 in 1991 (P = 0.001). For these other AIDS index diseases,
       significant rate increases were observed for esophageal candidiasis,
       cytomegalovirus (CMV) diseases, wasting syndrome, toxoplasmosis, and
       Mycobacterium avium complex (MAC) disease. CONCLUSIONS: Our study shows
       a leveling and decline in incidence of KS and PCP, respectively, and a
       concomitant increase of other diagnoses, especially esophageal
       candidiasis, CMV, wasting syndrome, toxoplasmosis, and MAC disease in
       Canada. These findings highlight the importance of developing specific
       strategies to prevent emerging AIDS index diseases and serve as a
       cautionary note to practicing clinicians, indicating the relative
       widening of the spectrum of HIV index diseases.
 DE    Acquired Immunodeficiency Syndrome/COMPLICATIONS/*DIAGNOSIS/
       EPIDEMIOLOGY  Adolescence  Adult  AIDS-Related Opportunistic
       Infections/*EPIDEMIOLOGY  Canada/EPIDEMIOLOGY  Candidiasis/EPIDEMIOLOGY
       Cytomegalovirus Infections/EPIDEMIOLOGY  Esophagitis/EPIDEMIOLOGY
       Female  Human  Incidence  Male  Middle Age  Mycobacterium
       avium-intracellulare Infection/EPIDEMIOLOGY  Pneumonia, Pneumocystis
       carinii/*EPIDEMIOLOGY  Risk Factors  Sarcoma, Kaposi's/*EPIDEMIOLOGY
       Support, Non-U.S. Gov't  Toxoplasmosis/EPIDEMIOLOGY  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

