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Lali Sharvadze MD, PhD Director of inpatient Department. Associated Professor. Overview of HIV/AIDS and ARV Treatment in Georgia.

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Presentation on theme: "Lali Sharvadze MD, PhD Director of inpatient Department. Associated Professor. Overview of HIV/AIDS and ARV Treatment in Georgia."— Presentation transcript:

1 Lali Sharvadze MD, PhD Director of inpatient Department. Associated Professor. Overview of HIV/AIDS and ARV Treatment in Georgia

2 25182518 1369 - AIDS Estimated number 3500 538 - Deaths Reported Cases of HIV/AIDS in Georgia

3 Women 665 Men 1853 Distribution of HIV/AIDS Patients by Sex and Age Groups Age distribution

4 Number of cases HIV Cases Registered in Georgia Annually

5 891 Tbilisi (55 Foreigners) Samegrelo 369 Kvemo Kartli 94 Kakheti 102 Svaneti 8 Abkhazia 168 Adjara 322 Guria 54 Imereti 319 Mtianeti 19 Shida Kartli 66 Samtskhe Javakheti 29 Lechkhumi 5 Poti 39 Distribution of HIV/AIDS Cases by Regions of Georgia (number of registered cases)

6 Incidence of AIDS Cases per 100 000 population (Source – WHO reports, 2007)

7 HIV Prevalence among High Risk Behavior Groups (2007) HIV Prevalence in General Population - 0.13

8 Distribution of HIV Cases by Routes of Transmission

9 AIDS Control Service in Georgia Country Coordinating Mechanism (CCM) Infectious Diseases, AIDS & Clinical Immunology Research Center Zugdidi AIDS treatment center Batumi AIDS treatment center 9 VCT centers in regions of Georgia 217 HIV diagnostic labs National Center of Disease Control and Public Health Kutaisi AIDS treatment center

10 Universal Access to HIV Treatment, Care and Support and Prevention Georgia is the First Among FSU Countries that from 2004 Ensured Universal (100%) Access to ARV Treatment. Georgia is the First Among FSU Countries that from 2004 Ensured Universal (100%) Access to ARV Treatment.

11 What Does It Mean - The Universal (100%) Access to ARV Treatment Georgian Approach Investigation of all HIV infected persons by special algorithm Investigation of all HIV infected persons by special algorithm To identify all patients requiring ARV treatment according to special criteria To identify all patients requiring ARV treatment according to special criteria To offer ARV therapy to all patients requiring treatment To offer ARV therapy to all patients requiring treatment Monitoring of all patients receiving ARV treatment

12 RUS* ARM* KAZ* KGZ*UZB* TKM TJK* AZE* BEL* UKR* no HAARTindividuals on HAART (<1%) * in the process of scaling up ART very poor access ( 1-25%)poor access (25-50%) disputed coverage estimates or insufficient data available moderate access (50-75%)good access (over 75%) ALB* FYM* Access to HAART GEO according to WHO/UNAIDS/UNICEF report on universal access of 2008

13 1984 – ELISA 1995 – 1995 – Qualitative PCR (Polymerase Chain Reaction) 1985 – 1985 – Western blot 1984 – 1984 – Immunophenotyping of CD3, CD4, CD8 lymphocytes 1996 – 1996 – Quantitative PCR (Polymerase Chain Reaction) 2003 – 2003 – HIV and HCV Genotyping 2005 – 2005 – HIV Genotypic Resistance Testing 2006 - 2006 - HIV subtype analysis using phylogenetic methods 2006 – 2006 – HIV, HCV & HBV quantitative- Real time PCR 2006 – 2006 – CCR5, CCR2 and SDF1 genotyping testing Implementation of Major Laboratory Methods in Georgia 2009 – 2009 – Abacavir hypersensitivity testing HLA-B*5701 SSP genotyping assay.

14 ARV implemented in Georgia NRTI AZT 3TC D4T DDI Abacavir Tenofovir FTC Téno/FTC Truvada® ABC/3TC NNRTI Nevirapine Viramune® Efavirenz Sustiva®* Protease Inhibitors (PI) Ritonavir Norvir® Indinavir Crixivan® Saquinavir Invirase® Nelfinavir Viracept® Lopinavir Kaletra ® Atazanavir Reyataz® Fosamprenavir Telzir ® Tipranavir Aptivus® Darunavir Prezista ® Entry inhibitor Enfuvirtide Integrase inhibitor Raltegravir

15 ARV Treatment 739 Patients are currently receiving ART 710 adults 710 adults 29 children

16 National Guidelines Criteria for Initiation of Antiretroviral Therapy Based on WHO and DHHS ART Guidelines History of an AIDS-defining illness; CD4 T - cell count <350 cells/mm 3 ; Patients with HIV-associated nephropathy; Patients co infected with HBV when treatment is indicated.

17 Georgian HIV/AIDS National Guidelines updated annually

18 Infectious Diseases, AIDS and Clinical Immunology Research Center Thank you for your attention!


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