Note to readers: From mid-2009, data produced by Health Protection Scotland (HPS) must conform to guidelines laid down by National Services Scotland (NSS) governing confidentiality and the suppression of small numbers which could result in disclosure. To this end, HPS are now in the process of reviewing and redeveloping the routine publication plan for HIV/AIDS data. It is hoped that the new plan will be implemented in 2010. In order to provide stakeholders with up to date information in advance of World AIDS Day (1 Dec 2009), HPS has prepared a limited set of data, presented herein, which highlights reporting from January to September 2009 along with cumulative figures.

HIV reports: 6153 AIDS cases: 1545 Total deaths: 1620 AIDS deaths: 998

Suppression of small numbers: Where data have been judged to be of a sensitive nature, figures with a value of less than five have been suppressed. In some circumstances, additional figures have been suppressed in order to nullify the ability to calculate data from totals.

In the nine-month period from 1 January to 30 September 2009, NHS Scotland laboratories reported positive HIV-antibody test results for 322 individuals not previously recorded as HIV-positive. The cumulative total of known HIV-positive individuals in Scotland is now 6153, of whom 4455 (72%) are male and 1698 (28%) are female (Table 1). At least 1620 (26%) are known to have died. Of the 322 recently reported HIV-positive individuals, 225 (70%) are male, and 220 (68%) are aged between 25 and 44 years (Table 2). The probable route of transmission was men who have sex with men (MSM) in 99 cases (including a small number who were also injecting drug users), heterosexual intercourse in 161 cases, and injecting drug use in 13 cases. Of the heterosexual cases, 84 probably acquired their infection abroad. For 42 cases, the transmission category is, as yet, undetermined. Of the total, 155 cases were reported from Greater Glasgow & Clyde, 58 from Lothian, 25 from Grampian, and 21 from Tayside (Table 3).
Of the 322 cases reported during the third quarter of 2009, 154 (48%) are presumed to have acquired their infection outwith Scotland. This compares with 39% (2317/6153) of the total reports received to 30 September 2009 (Table 4).

Between January 1 and 30 September 2009, 58 cases of AIDS were reported by clinicians, several of which had been diagnosed in previous years. The cumulative number of AIDS cases is now 1545, of whom 1221 (79%) are male, while 998 (65%) are known to have died. Of the newly reported AIDS cases, 24 were from Lothian, 24 were from Greater Glasgow & Clyde, and 41 were male. (Data not shown).

During the period 1 July 2008 to 30 June 2009, 3007 persons had at least one CD4 count performed: 268 (9%) had a count <200 cells/mm³, 1360 (45%) a count of between 201 and 500, and 1372 (46%) a count of > 500. The majority of cases were from the Lothian (1044, 35%) and Greater Glasgow & Clyde (963, 32%) areas (Table 5). Across Scotland, three-quarters of cases attending for CD4 monitoring are receiving triple therapy or higher.

Of the 234 cases who entered monitoring for the first time between 1 January and 30 June 2009, 55 (24%) had a count <200 , 96 (41%) a count between 201 and 500, and 80 (34%) a count of > 500. (Data not shown).

In the 12 months prior to 30 June 2009, 2803 persons had at least one viral load test performed, 2144 (76%) of whom had evidence of reasonable viral control indicated by a viral load measure of <400 copies/ml. Of the 421 cases that entered monitoring for the first time in the same period, 228 (54%) had a viral load <400 (Table 6).

To reduce the effects of reporting delay, the data presented in Tables 5 and 6 are three months in arrears.

Continuing investigation into previously reported cases has resulted in the enhancement of several records with additional epidemiological information, and the addition of several previously unrecorded 2008 cases. See Table 7 for detailed updates to totals in transmission categories, NHS boards, and other figures.

The HIV-positive and AIDS databases are under continual review and modification as additional information becomes available. This may result in apparent discrepancies when current and previously published tables are compared.

Acknowledgements - HIV Surveillance Coordinators and Collaborators

SCOTLAND:

Aberdeen and North East Scotland Blood Transfusion Service, Aberdeen: Ms I Gray, Dr S Urbaniak, Mr D Wilson

Ayrshire & Arran NHS Board, Ayr: Dr M Smellie

Borders General Hospital, Melrose: Ms E Anderson, Dr D Clutterbuck, Mr P Machell

Borders NHS Board, Melrose: Dr Tim Patterson

Crosshouse Hospital, Kilmarnock: Ms L Bruce, Dr G Downie, Ms A Lundie, Dr G Williams, Mr B Wilson

Dumfries & Galloway NHS Board: Dr D Breen

Dumfries & Galloway Royal Infirmary: Mr M Gray, Dr G Jones, Dr P Rafferty, Dr F Toolis

East of Scotland Blood Transfusion Service, Ninewells Hospital, Dundee: Dr G Galea

Falkirk & District Royal Infirmary: Dr J Harvey, Ms A Paterson, Dr Abu-Rajab

Fife Health Board, Cupar: Dr C Saunders

Forth Valley Health Board, Stirling: Dr H Prempeh

Gartnavel General Hospital, Glasgow: Dr S Cameron, Dr W Carman, Ms R Raajaravi, Dr R Fox, Ms H Paterson, Ms L McDonald, Dr A Seaton, Dr R Wong

Glasgow Royal Infirmary: Ms R Connor, Sis E Little, Prof G Lowe, Ms N Brodie

Glasgow & West of Scotland Blood Transfusion Service, Glasgow: Dr B Dow, Dr D Frame, Dr R Green

Grampian NHS Board, Aberdeen: Dr M Rossi

Grampian University Hospitals NHS Trusts: Dr S Armstrong, Mr I Collacott, Dr G Douglas, Ms J Findlay, Dr R Herriot, Ms K Hughes, Dr R Laing, Dr G McKenna, Dr P Molyneaux, Dr T Reid, Dr D Richards

Greater Glasgow & Clyde NHS Board, Glasgow: Dr S Ahmed

Hairmyres Hospital, East Kilbride: Dr D Baird, Mr F Christianson, Mr M Stewart

Health Protection Scotland: Mr F Boero, Mrs E Carragher, Ms P Cassels, Ms M King, Miss M McNicol, Mr D Nicholson, Ms J Reilly, Mr W Smyth, Ms B Wayne

Highland NHS Board, Inverness: Mr K Hepburn, Dr K Oates

Inverclyde Royal Hospital, Greenock: Dr E Biggs, Ms M McDougall, Dr P Semple

Lanarkshire NHS Board, Hamilton: Dr J Logan

Lothian NHS Board, Edinburgh: Dr C Evans

Monklands Hospital, Airdrie: Ms I Glen, Dr N Kennedy, Ms L McCann, Dr S Rafters, Dr J Roberts, Ms H Robertson, Ms M Roche, Ms R Thomson, Dr A Todd, Mr J Westwater, Ms I Winning

Muirhouse Practice, Edinburgh: Dr R Robertson

Ninewells Hospital, Dundee: Mr K Appleyard, Dr P Davey, Mr N Docherty, Dr A France, Mr J Gibbs, Ms W Lees, Sis A Lovelady(Perth), Dr W McGuire, Dr P McIntyre, Dr N Murdoch, Sis W Mutch, Dr D Nathwani, Mr R Potts, Ms M Reid, Ms D Ross, Dr R Smith, Ms M Taylor, Mr J Wallace, Mr E Wooldridge and Dr D Yirrell

North of Scotland Blood Transfusion Service, Raigmore Hospital, Inverness: Dr T Ferguson, Dr P Forsyth, Dr S Lumley

Orkney NHS Board, Kirkwall: Dr K Black

Raigmore Hospital, Inverness: Mr T Bell, Ms J Ferguson, Dr D Ho-Yen, Dr Khan

Royal Alexandra Hospital, Paisley: Ms A Cairns, Mr I Connell, Mr J Mallon

Royal Hospital for Sick Children, Edinburgh: Dr J Mok

Royal Infirmary, Edinburgh: Dr S Burns, Dr J Dave, Sis L Docking, Dr S Lawson, Ms G Leadbetter, Dr W A Liston, Prof A Ludlum, Dr A McMillan, Ms F McNeilage, Ms P Munro, Dr M Ogilvie,Dr G Scott, Dr S Sutherland, Dr C Thompson

Sandyford Initiative, Glasgow: Ms F Harper, Mr M Murchie, Dr R Nandwani, Dr G Sharp, Dr A Winter

Scottish National Blood Transfusion Service, Edinburgh: Dr J Gillon, Mr A Jordan, Mr A MacMillian, Dr B McClelland, Dr R Perry, Dr C Prowse, Dr P L Yap

Scottish Government: Dr E Stewart, Ms Jacquiline Campbell, Mr M McCormack

Shetland NHS Board, Lerwick: Dr S Taylor

Southern General Hospital, Glasgow: Mr J Guthrie, Ms E Scott, Mr J Winning

Stirling Royal Infirmary: Mr G Inglis, Dr J McGavigan

Tayside NHS Board, Dundee: Dr C. McGuigan

Victoria Hospital, Kirkcaldy: Dr I Banerjee, Dr D Bhattacharyya, Ms B Cowper, Dr C Lafong, Dr I Laurenson

Western General Hospital, Edinburgh: Dr R P Brettle, Dr C L S Leen, Dr P Welsby, Dr D Wilks, Mr A Wilson, M J Wallace

Western Infirmary, Glasgow: Mr E Galloway, Dr A Peacock, Ms C Ross

Western Isles NHS Board, Stornoway, Isle of Lewis: Dr A George

Wishaw General Hospital, Wishaw, Lanarkshire: Mrs A Hughes, Dr K Liddell, Mr I McCormick

Yorkhill Hospital, Glasgow: Dr D Aitken, Ms L Bain, Ms A Brown, Dr R Hague, Dr M Hepburn, Ms J McKenzie, Ms L McNairney, Dr D Tappin

ENGLAND:

HPA Communicable Disease Surveillance Centre, London: Mr T Chadborn, Ms S Cliffe, Dr V Delpech, Dr B Evans, Prof O N Gill, Dr F Ncube, Dr B Rice, Ms R Smith

Institute of Child Health, University of London: Ms J Masters, Prof C Peckham, Dr P Tookey, Ms C Townsend

• http://www.documents.hps.scot.nhs.uk/ewr/pdf2009/0947.pdf

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• Blood, Bloodborne Infections
• Drug Misuse
• HIV/AIDS
• Infectious Diseases
• Sexually Transmitted Infections
• Viruses

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