1. Overview of the HIV epidemic in Romania Participants: Dr. Ruxandra Calin – Matei Bals National Institute of Infectious Diseases, Bucharest Dr. Elena Dumea – Infectious Diseases Clinical Hospital, Constanta Dr. Raluca Mihailescu – Matei Bals National Institute of Infectious Diseases, Bucharest Montpellier, September 2010

2. The context Around 21 million inhabitants Maximum HIV case incidence 1990 – 1995 (the late 80s epidemiological accident), followed by 1995 – 2000 steep drop Dominant subtype: F June 2010: prevalence rate of 24,7 cases/100.000 inhabitants Highest number of PLHA under treatment in Central/Eastern Europe - 7.244, relative to the total number of HIV persons alive ( 10.145) Around 6000 are young adults 20 – 29 yo HIV/AIDS Monitoring and Evaluation Department of the National AIDS Comission for Romania – Matei Bals National Institute of Infectious Diseases Paraschi S, Foley B, Otelea D, Diversity of HIV-1 subtype C stains isolated in Romania, Infect Gent Evol,2010, Jul 8, Epub ahead of print

3. Long term survivors – yesterdays children, todays parents No of cases June 2010, HIV/AIDS Monitoring and Evaluation Department of the National AIDS Comission for Romania – Matei Bals National Institute of Infectious Diseases Age at diagnostic – cumulative total 1985 - 2010Actual age in 2010

4. HIV cases in Romania – incidence and transmission route HIV incidence 1992-2009 (per 100.000 ) Probable route of transmission for HIV adults (>14 yo at diagnostic) – cumulativ total 1992-2010 June 2010, HIV/AIDS Monitoring and Evaluation Department of the National AIDS Comission for Romania – Matei Bals National Institute of Infectious Diseases UNKNOWN HETERO BLOOD/DERIV * IVDUHOMO/BI ChildrenAdults Male Female

5. Regional comparison 1996 - 2006 Eurohiv.org - The HIV/AIDS epidemic in the WHO European Region at end 2006 Newly diagnosed HIV infections 1996 - 2006 AIDS cases 1996 - 2006

6. Coinfection distribution in Romania HIV-HBV/HCV/HDV among 240 coinfected patients at Matei Bals National Institute of Infectious Diseases Streinu-Cercel A, Survey of coinfections in Romania, National Congress of HiV/AIDS, Bucharest,oral presentation, May 2010

7. Current trends Mean survival period: 3 months (1990) -> 84 months (2009) Access, although variable, to all newest antiretrovirals (except some combinations); universal access Increasing number of HIV patients seeking medical care Increasing awareness and attention given to coinfections (especially TB, HBV, HCV) Increasing number of adults infected heterosexually HIV/AIDS Monitoring and Evaluation Department of the National AIDS Comission for Romania – Matei Bals National Institute of Infectious Diseases

8. Thank you!