TY - RPRT T1 - Epidémiologie du VIH en Belgique. Situation au 31 décembre 2022. Y1 - 2023 A1 - Jessika Deblonde A1 - Ben Serrien A1 - Maarten De Rouck A1 - Marion Montourcy A1 - Dominique Van Beckhoven KW - SIDA KW - VIH PB - Sciensano CY - Brussels, Belgium ER - TY - RPRT T1 - Epidemiologie van hiv in België. Toestand op 31 december 2022. Y1 - 2023 A1 - Jessika Deblonde A1 - Ben Serrien A1 - Maarten De Rouck A1 - Marion Montourcy A1 - Dominique Van Beckhoven KW - AIDS KW - HIV PB - Sciensano CY - Brussels, Belgium ER - TY - JOUR T1 - Prevalence of chronic HCV infection in EU/EEA countries in 2019 using multiparameter evidence synthesis JF - The Lancet Regional Health - Europe Y1 - 2023 A1 - Christos Thomadakis A1 - Ilias Gountas A1 - Erika Duffell A1 - Konstantinos Gountas A1 - Benjamin Bluemel A1 - Thomas Seyler A1 - Filippo Maria Pericoli A1 - Irene Kászoni-Rückerl A1 - Ziad El-Khatib A1 - Martin Busch A1 - Irene Schmutterer A1 - Thomas Vanwolleghem A1 - Sofieke Klamer A1 - E Plettinckx A1 - Laure Mortgat A1 - Dominique Van Beckhoven A1 - Tonka Varleva A1 - Mirjana Lana Kosanovic Licina A1 - Tatjana Nemeth Blazic A1 - Diana Nonković A1 - Fanitsa Theophanous A1 - Vratislav Nemecek A1 - Marek Maly A1 - Christensen, Peer Brehm A1 - Cowan, Susan A1 - Kristi Rüütel A1 - Henrikki Brummer-Korvenkontio A1 - Cécile Brouard A1 - Steffen, Gyde A1 - Amrei Krings A1 - Sandra Dudareva A1 - Ruth Zimmermann A1 - Georgia Nikolopoulou A1 - Zsuzsanna Molnár A1 - Kozma, Emese A1 - Magnús Gottfredsson A1 - Niamh Murphy A1 - Loreta A. Kondili A1 - Maria Elena Tosti A1 - Anna Rita Ciccaglione A1 - Suligoi, Barbara A1 - Raina Nikiforova A1 - Renate Putnina A1 - Ligita Jancoriene A1 - Carole Seguin-Devaux A1 - Tanya Melillo A1 - Anders Boyd A1 - Marc van der Valk A1 - Op de Coul, Eline A1 - Robert Whittaker A1 - Hilde Kløvstad A1 - Małgorzata Stępień A1 - Magdalena Rosińska A1 - Cristina Valente A1 - Rui Tato Marinho A1 - Odette Popovici A1 - Mária Avdičová A1 - Jana Kerlik A1 - Irena Klavs A1 - Mojca Maticic A1 - Díaz, Asunción A1 - Del Amo, Julia A1 - Josefine Lundberg Ederth A1 - Axelsson, Maria A1 - Nikolopoulos, Georgios KW - Chronic hepatitis KW - Elimination KW - Europe KW - HCV KW - Hepatitis C KW - prevalence M3 - 10.1016/j.lanepe.2023.100792 ER - TY - RPRT T1 - Surveillance des infections sexuellement transmissibles. Situation épidémiologique jusqu' au 31 décembre 2021 Y1 - 2023 A1 - Amaryl Lecompte A1 - Wim Vanden Berghe A1 - Sherihane Bensemmane A1 - Dorien Van Den Bossche A1 - Irith De Baetselier A1 - Dominique Van Beckhoven PB - Sciensano CY - Brussels ER - TY - RPRT T1 - Surveillance van seksueel overdraagbare infecties. Epidemiologische situatie op 31 december 2021 Y1 - 2023 A1 - Amaryl Lecompte A1 - Wim Vanden Berghe A1 - Sherihane Bensemmane A1 - Dorien Van Den Bossche A1 - Irith De Baetselier A1 - Dominique Van Beckhoven KW - chlamydia KW - gonorroe KW - seksueel overdraagbare aandoeningen KW - syfilis PB - Sciensano CY - Brussels ER - TY - JOUR T1 - Changes in anticancer treatment plans in patients with solid cancer hospitalized with COVID-19: analysis of the nationwide BSMO-COVID registry providing lessons for the future JF - ESMO Open Y1 - 2022 A1 - T. Geukens A1 - M. Brandão A1 - A. Laenen A1 - J. Collignon A1 - C. Van Marcke A1 - I. Louviaux A1 - W. Demey A1 - S. Van Wambeke A1 - D. Schrijvers A1 - S. Lecomte A1 - J. Mebis A1 - A. Rutten A1 - C. Fontaine A1 - W. Lybaert A1 - S. Aspeslagh A1 - J.-C. Goeminne A1 - H. Van Den Bulck A1 - E. Seront A1 - L. De Backer A1 - W. De Roock A1 - M. Ignatiadis A1 - H. Prenen A1 - Dominique Van Beckhoven A1 - M. Heijlen A1 - J. Verheezen A1 - S. Rottey A1 - K. Punie A1 - E. de Azambuja VL - 7 CP - 6 M3 - 10.1016/j.esmoop.2022.100610 ER - TY - RPRT T1 - Epidémiologie du sida et de l'infection à VIH en Belgique. Situation au 31 décembre 2021. Y1 - 2022 A1 - Jessika Deblonde A1 - Ben Serrien A1 - Maarten De Rouck A1 - Marion Montourcy A1 - Dominique Van Beckhoven PB - Sciensano CY - Bruxelles ER - TY - RPRT T1 - Epidemiologie van aids en hiv-infectie in België. Toestand op 31 december 2021 Y1 - 2022 A1 - Jessika Deblonde A1 - Ben Serrien A1 - Maarten De Rouck A1 - Marion Montourcy A1 - Dominique Van Beckhoven KW - AIDS KW - HIV KW - soi ER - TY - JOUR T1 - Impact of COVID-19 on the Belgian HIV epidemic: slowdown of HIV transmission and testing and adaptation of care. JF - BMC Infect Dis Y1 - 2022 A1 - Dominique Van Beckhoven A1 - Ben Serrien A1 - Marion Montourcy A1 - Verhofstede, Chris A1 - Dorien Van den Bossche A1 - Agnes Libois A1 - Deborah De Geyter A1 - Thierry Martin A1 - Sandra Van den Eynde A1 - Vuylsteke, Bea A1 - Gilles Darcis A1 - Karlijn van Halem A1 - Florence, Eric A1 - Jessika Deblonde KW - Belgium KW - Communicable Disease Control KW - COVID-19 KW - HIV Infections KW - Humans KW - Pandemics AB -

BACKGROUND: To gain insight into the impact of the COVID-19 pandemic and containment measures on the HIV epidemic and services, this study aims to describe HIV trends in 2020 and compare them with previous years.

METHODS: Belgian national HIV surveillance data 2017-2020 were analysed for trends in HIV testing, HIV diagnoses, VL measurements, ART uptake and PrEP purchase. Descriptive statistics from 2020 are compared to annual averages from 2017 to 2019 (proportional difference, %).

RESULTS: In 2020, 725 HIV infections were diagnosed in Belgium (- 21.5% compared to 2019). The decline was most pronounced during the first lockdown in April-May but also present in July-December. The number of HIV tests performed decreased by 17.6% in 2020, particularly in March-May and October-December (- 57.5% in April and -25.4% in November 2020 compared to monthly 2017-19 numbers). Diagnosis of acute HIV infections decreased by 47.1% in 2020 (n = 27) compared to 2019 (n = 51). Late HIV diagnoses decreased by 24.7% (95% CI [- 40.7%; -9.7%]) in 2020 compared to 2019. Of patients in care in 2019, 11.8% interrupted HIV care in 2020 compared to 9.1% yearly in the 3 previous years. The number of HIV patients with VL monitoring per month dropped in March-May 2020, whilst proportions of VL suppression and ART coverage remained above 86% and 98.5% respectively in 2020. PrEP purchases, number of purchasers and starters dropped during April-May 2020 (respectively - 45.7%, - 47.4%, - 77.9% in April compared to February 2020).

CONCLUSIONS: The significant decrease in HIV diagnoses in Belgium in 2020 coincided with the COVID-19 pandemic and following containment measures, particularly in April-May during the first lockdown. A slowdown of HIV transmission due to reduced HIV risk exposure is suggested by the halving in diagnosis of acute HIV infections in March-December 2020 compared to the previous year, and the adaptive decrease in PrEP use and PrEP initiation from April onwards. Despite a slight increase in HIV care interruptions, the indicators of quality of HIV care remained stable. Access to prevention, testing and care for all people living with HIV and at risk of acquiring HIV is a priority during and after times of pandemic.

VL - 22 CP - 1 M3 - 10.1186/s12879-022-07879-1 ER - TY - JOUR T1 - Late Diagnosis Definition Working Group. Late diagnosis of HIV: An updated consensus definition. JF - HIV Medicine Y1 - 2022 A1 - Croxford, Sara A1 - Annemarie Rinder Stengaard A1 - Johanna Brännström A1 - Lauren Combs A1 - Nikos Dedes A1 - Girardi, Enrico A1 - Sophie Grabar A1 - Ole Kirk A1 - Giorgi Kuchukhidze A1 - Jeffrey V. Lazarus A1 - Noori, Teymur A1 - Pharris, Anastasia A1 - Dorthe Raben A1 - Jürgen K. Rockstroh A1 - Daniel Simões A1 - Ann K. Sullivan A1 - Dominique Van Beckhoven A1 - Valerie C. Delpech KW - HIV KW - HIV diagnosis VL - 23 CP - 11 M3 - 10.1111/hiv.13425 ER - TY - Generic T1 - Prevalence of Undiagnosed HIV infections Belgium, 2020. Description by place of residence, urbanization level and key subpopulations. Y1 - 2022 A1 - Ben Serrien A1 - Marion Montourcy A1 - Maarten De Rouck A1 - Delforge, Marie-Luce A1 - Marie-Pierre Hayette A1 - Kabamba, Benoît A1 - Piérard, Denis A1 - Stoffels, Karolien A1 - Dorien Van den Bossche A1 - Kristel Van Laethem A1 - Verhofstede, Chris A1 - Jessika Deblonde A1 - Dominique Van Beckhoven JF - International Workshop on HIV and Hepatitis Observational Databases (IWHOD) ER - TY - RPRT T1 - Epidémiologie du SIDA et de l'infection à VIH en Belgique. Situation au 31 décembre 2020. Y1 - 2021 A1 - Jessika Deblonde A1 - Maarten De Rouck A1 - Marion Montourcy A1 - Ben Serrien A1 - Dominique Van Beckhoven KW - AIDS KW - HIV KW - SIDA KW - VIH PB - Sciensano CY - Belgium, Brussels ER - TY - RPRT T1 - Epidemiologie van aids en hiv-infectie in België. Toestand op 31 december 2020. Y1 - 2021 A1 - Jessika Deblonde A1 - Maarten De Rouck A1 - Marion Montourcy A1 - Ben Serrien A1 - Dominique Van Beckhoven KW - AIDS KW - HIV KW - SIDA KW - VIH PB - Sciensano CY - Belgium, Brussels ER - TY - JOUR T1 - Insights into the association of ACEIs/ARBs use and COVID-19 prognosis: a multistate modelling study of nationwide hospital surveillance data from Belgium. JF - BMJ Open Y1 - 2021 A1 - José L Peñalvo A1 - Els Genbrugge A1 - Elly Mertens A1 - Diana Sagastume A1 - Marianne A B van der Sande A1 - Marc-Alain Widdowson A1 - Dominique Van Beckhoven KW - Aged KW - Angiotensin Receptor Antagonists KW - Angiotensin-Converting Enzyme Inhibitors KW - Belgium KW - COVID-19 KW - Hospital Mortality KW - hospitals KW - Humans KW - Hypertension KW - Male KW - SARS-CoV-2 AB -

OBJECTIVES: The widespread use of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) by patients with chronic conditions raised early concerns on the potential exacerbation of COVID-19 severity and fatality. Previous studies addressing this question have used standard methods that may lead to biased estimates when analysing hospital data because of the presence of competing events and event-related dependency. We investigated the association of ACEIs/ARBs' use with COVID-19 disease outcomes using time-to-event data in a multistate setting to account for competing events and minimise bias.

SETTING: Nationwide surveillance data from 119 Belgian hospitals.

PARTICIPANTS: Medical records of 10 866 patients hospitalised from 14 March 2020to 14 June 2020 with a confirmed SARS-CoV-19 infection and information about ACEIs/ARBs' use.

PRIMARY OUTCOME MEASURE: Multistate, multivariate Cox-Markov models were used to estimate the hazards of patients transitioning through health states from admission to discharge or death, along with transition probabilities calculated by combining the baseline cumulative hazard and regression coefficients.

RESULTS: After accounting for potential confounders, there was no discernable association between ACEIs/ARBs' use and transfer to intensive care unit (ICU). Contrastingly, for patients without ICU transfer, ACEIs/ARBs' use was associated with a modest increase in recovery (HR 1.07, 95% CI 1.01 to 1.13, p=0.027) and reduction in fatality (HR 0.83, 95% CI 0.75 to 0.93, p=0.001) transitions. For patients transferred to ICU admission, no evidence of an association between ACEIs/ARBs' use and recovery (HR 1.16, 95% CI 0.97 to 1.38, p=0.098) or in-hospital death (HR 0.91, 95% CI 0.73 to 1.12, p=0.381) was observed. Male gender and older age were significantly associated with higher risk of ICU admission or death. Chronic cardiometabolic comorbidities were also associated with less recovery.

CONCLUSIONS: For the first time, a multistate model was used to address magnitude and direction of the association of ACEIs/ARBs' use on COVID-19 progression. By minimising bias, this study provided a robust indication of a protective, although modest, association with recovery and survival.

VL - 11 CP - 9 M3 - 10.1136/bmjopen-2021-053393 ER - TY - JOUR T1 - Organizational characteristics: Effect on outcome of ICU COVID-19 patients in Belgium - Authors' reply. JF - Lancet Reg Health Eur Y1 - 2021 A1 - Fabio Silvio Taccone A1 - Nina Van Goethem A1 - Robby De Pauw A1 - Dominique Van Beckhoven A1 - Meyfroidt,G. A1 - Koen Blot VL - 3 M3 - 10.1016/j.lanepe.2021.100070 ER - TY - JOUR T1 - Post-migration acquisition of HIV: Estimates from four European countries, 2007 to 2016. JF - Euro Surveill Y1 - 2021 A1 - Yin, Zheng A1 - Alison E Brown A1 - Brian D Rice A1 - Gaetano Marrone A1 - Sonnerborg, Anders A1 - Suligoi, Barbara A1 - André Sasse A1 - Dominique Van Beckhoven A1 - Noori, Teymur A1 - Vincenza Regine A1 - Valerie C Delpech KW - CD4 Lymphocyte Count KW - Europe KW - HIV Infections KW - Humans KW - Risk Factors KW - Transients and Migrants AB -

BackgroundThe assumption that migrants acquire human immunodeficiency virus (HIV) before migration, particularly those from high prevalence areas, is common.AimWe assessed the place of HIV acquisition of migrants diagnosed in four European countries using surveillance data.MethodsUsing CD4+ T-cell count trajectories modelled to account for seroconversion bias, we estimated infection year of newly HIV-diagnosed migrants residing in the United Kingdom (UK), Belgium, Sweden and Italy with a known arrival year and CD4+ T-cell count at diagnosis. Multivariate analyses identified predictors for post-migration acquisition.ResultsBetween 2007 and 2016, migrants constituted 56% of people newly diagnosed with HIV in the UK, 62% in Belgium, 72% in Sweden and 29% in Italy. Of 23,595 migrants included, 60% were born in Africa and 70% acquired HIV heterosexually. An estimated 9,400 migrants (40%; interquartile range (IQR): 34-59) probably acquired HIV post-migration. This proportion was similar by risk group, sex and region of birth. Time since migration was a strong predictor of post-migration HIV acquisition: 91% (IQR: 87-95) among those arriving 10 or more years prior to diagnosis; 30% (IQR: 21-37) among those 1-5 years prior. Younger age at arrival was a predictor: 15-18 years (81%; IQR: 74-86), 19-25 years (53%; IQR: 45-63), 26-35 years (37%; IQR: 30-46) and 36 years and older (25%; IQR: 21-33).ConclusionsMigrants, regardless of origin, sex and exposure to HIV are at risk of acquiring HIV post-migration to Europe. Alongside accessible HIV testing, prevention activities must target migrant communities.

VL - 26 CP - 33 M3 - 10.2807/1560-7917.ES.2021.26.33.2000161 ER - TY - JOUR T1 - Prevalence estimates of genital Chlamydia trachomatis infection in Belgium: results from two cross-sectional studies. JF - BMC Infect Dis Y1 - 2021 A1 - Nathalie Fischer A1 - Ilse Peeters A1 - Sofieke Klamer A1 - Marion Montourcy A1 - Vicky Cuylaerts A1 - Dominique Van Beckhoven A1 - Irith De Baetselier A1 - Johan Van der Heyden A1 - Wim Vanden Berghe KW - ADOLESCENT KW - Adult KW - Belgium KW - Chlamydia Infections KW - Chlamydia trachomatis KW - cross-sectional studies KW - Female KW - Genitalia KW - Humans KW - Male KW - middle aged KW - prevalence KW - Risk Factors KW - Sexual Behavior KW - STI KW - Young adult AB -

BACKGROUND: Chlamydia trachomatis (chlamydia) is the most diagnosed sexually transmitted infection in Belgium. Screening programs focus on young women, due to the implications of chronic asymptomatic infections for reproductive health. Thereby, the frequency of infections in men and older adults is underestimated. This study aimed to estimate the point-prevalence of chlamydia in the broader Belgian population, to inform evidence-based prevention and control strategies.

METHODS: We conducted two cross-sectional prevalence studies of chlamydia infection in the population of Belgium aged 16-59 years, 2018-2020. In the CT1 study 12,000 representative individuals were randomly selected from the national register and invited by letter to collect a urine sample at home. The CT2 study used urine samples collected through the Belgian Health Examination Survey. Molecular detection of chlamydia DNA was performed using Xpert or Abbott Real-Time CT/NG assays. Weighted estimated prevalence and 95% confidence interval (CI) was calculated per gender and age groups of 16/18-29, 30-44 and 45-59 years, relative to the general Belgian population. Data collected on sociodemographic variables and sexual behavior were used to identify potential risk factors for chlamydia infection through calculation of the odds ratio (OR).

RESULTS: The population-wide weighted estimated prevalence was 1.54% (95% CI 0.78-3) in CT1 and 1.76% (95% CI 0.63-4) in CT2. We observed no statistically significant difference between men and women or age groups. Civil relationship status (OR = 14.1 (95% CI 1.78-112), p < 0.01), sexual intercourse with a casual partner (OR = 6.31 (95% CI 1.66-24.1), p < 0.01) and > 3 sexual partners in the last 12 months (OR = 4.53 (95% CI 1.10-18.6), p = 0.02) were associated with higher relative risk for chlamydia infection.

CONCLUSION: Nationwide prevalence studies are relevant to assess the distribution of chlamydia and inform public health actions. The overall low prevalence and heterogeneous distribution of chlamydia in the general Belgian population needs to be considered for future strategies and potential harm of testing and treating asymptomatic individuals need to be taken into account. Effective case management should include appropriate treatment of symptomatic patients and partner notification, and prevention strategies should encourage behaviors such as condom use.

VL - 21 CP - 1 M3 - 10.1186/s12879-021-06646-y ER - TY - JOUR T1 - Reply to "The perceived efficacy of hydroxychloroquine in observational studies: the results of the confounding effects of 'goals of care'". JF - Int J Antimicrob Agents Y1 - 2021 A1 - Nicolas Dauby A1 - Joris Hautekiet A1 - Lucy Catteau A1 - Marion Montourcy A1 - Dominique Van Beckhoven A1 - Bottieau, Emmanuel A1 - Goetghebeur, Els KW - COVID-19 KW - Humans KW - Hydroxychloroquine KW - Patient Care Planning VL - 57 CP - 4 M3 - 10.1016/j.ijantimicag.2021.106307 ER - TY - JOUR T1 - The role of organizational characteristics on the outcome of COVID-19 patients admitted to the ICU in Belgium JF - The Lancet Regional Health - Europe Y1 - 2021 A1 - Fabio Silvio Taccone A1 - Nina Van Goethem A1 - Robby De Pauw A1 - Xavier Wittebole A1 - Koen Blot A1 - Herman Van Oyen A1 - Tinne Lernout A1 - Marion Montourcy A1 - Geert Meyfroidt A1 - Dominique Van Beckhoven M3 - 10.1016/j.lanepe.2020.100019 ER - TY - RPRT T1 - COVID-19-infectie bij kinderen in België. Resultaten van labo-surveillance, schoolgegevens en ziekenhuis surveillance 15/03-28/06/2020 Y1 - 2020 A1 - Laura Cornelissen A1 - Amber Litzroth A1 - Marion Montourcy A1 - Maarten De Rouck A1 - Chloé Wyndham-Thomas A1 - Sofieke Klamer A1 - Dominique Van Beckhoven AB -

Kinderen zijn niet zomaar “kleine volwassenen”, ze vormen een aparte groep die zowel lichamelijk als qua sociale omstandigheden verschilt van de volwassen bevolking en die bijzondere aandacht verdient. Dit rapport gaat dieper in op deze specifieke groep en brengt gegevens uit verschillende Belgische COVID-19-gerelateerde databronnen samen. Het totaal aantal bevestigde gevallen van COVID-19 bij kinderen ligt laag. Dit wordt vaak toegeschreven aan het feit dat kinderen minder getest werden. De laboratoriumgegevens tonen aan dat dat maar ten dele klopt. Kinderen werden inderdaad minder vaak getest: ze vormen 20% van de Belgische bevolking, maar slechts 10% van het totaal aantal testen. Maar ook als kinderen wel getest worden, is de test minder vaak positief dan bij volwassenen (gemiddeld 1,8% tegenover 6,3%). Het aantal testen bij kinderen lag vooral laag in het begin van de epidemie, toen testen voorbehouden werden voor ernstige gevallen. Na de wijzigingen in de teststrategie op 4 mei (elk mogelijk geval kan getest worden) en op 11 juni (alle nauwe contacten van een bevestigd geval moeten ook getest worden), zien we het aantal testen bij kinderen sterk stijgen. Tijdens het grootste deel van de periode die in dit rapport beschreven wordt, was afstandsonderwijs de regel, zeker voor de leerlingen van de middelbare scholen. In totaal werden 378 gevallen op school gemeld, waarvan 270 bij leerlingen en 108 bij personeelsleden. De meldingen op school leidden ertoe dat meer dan 4 715 personen (waarvan 243 volwassenen) preventief in quarantaine werden geplaatst. Het hoge aantal personen in quarantaine staat in contrast met het beperkt aantal secundaire gevallen dat gerapporteerd werd: 11 personeelsleden (4,7% van de personeelsleden in quarantaine) en 36 leerlingen (0,8% van de 4 472 leerlingen in quarantaine) werden vermoedelijk besmet na contact op school. De meerderheid van de kinderen die positief testten voor SARS-CoV-2 moest niet in het ziekenhuis worden opgenomen. Hoewel ze 3% uitmaken van het aantal personen met een bevestigde infectie, maakten ze maar 1,6% uit van het totaal aantal gehospitaliseerde patiënten met COVID-19. Het overgrote deel (81%) van de ziekenhuisopnames bij kinderen verliep bovendien zonder ernstige complicaties (zoals longontsteking, bacteriële surinfectie of schimmelinfectie, opname op intensieve zorgen en acuut respiratoir stresssyndroom). De verblijfsduur van kinderen in het ziekenhuis was dan ook meestal kort (mediaan = 3 dagen) en lag beduidend lager dan die voor alle patiënten in de hospitaalsurveillance (mediaan = 8 dagen). De allerjongsten, met name kinderen jonger dan 3 maanden, vertegenwoordigen een groot deel van deze hospitalisaties bij kinderen. Dit wordt vermoedelijk verklaard door het feit dat koorts bij deze jonge kinderen een alarmsignaal is dat snel tot het uitvoeren van een diagnostische test leidt (wat de kans op een bevestiging van de diagnose verhoogt) en het feit dat een positieve test in deze leeftijdsgroep meer bezorgdheid opwekt (en dus sneller zal leiden tot opname in het ziekenhuis). Ondanks de vaststelling dat jongere kinderen vaker gehospitaliseerd worden, lijken het, op basis van onze gegevens, net de oudere leeftijdsgroepen (1 jaar of ouder vergeleken met jonger dan 1 jaar) te zijn die meer risico lopen op een ernstiger ziekteverloop. Mogelijk worden deze gegevens vertekend door het gegeven dat, zoals hierboven besproken, jonge kinderen sneller getest en gehospitaliseerd worden.

ER - TY - JOUR T1 - Development and Evaluation of an HIV-Testing Intervention for Primary Care: Protocol for a Mixed Methods StudyBackgroundObjectiveMethodsResultsConclusionsTrial RegistrationInternational Registered Report Identifier (IRRID) JF - JMIR Research Protocols Y1 - 2020 A1 - Hanne Apers A1 - Vuylsteke, Bea A1 - Loos, Jasna A1 - Tom Smekens A1 - Jessika Deblonde A1 - Dominique Van Beckhoven A1 - Nöstlinger, Christiana KW - HIV KW - prevention KW - TESTING AB -

Background: Late diagnosis of HIV fosters HIV transmission and may lead to hidden HIV epidemics. In Belgium, mathematical modeling indicates a high prevalence of undiagnosed HIV infections among men who have sex with men of non-Belgian origin and among sub-Saharan African migrants. Promotion of HIV testing facilitates early diagnosis, but diagnostic opportunities are missed in primary care.

Objective: The intervention study aims to enhance provider-initiated HIV testing by GPs. This protocol presents the conceptual development, implementation, and evaluation of an HIV-testing intervention for Flemish general practitioners (GPs).

Methods: A mixed methods evaluation design is used. Guided by a simplified intervention mapping approach, an evidence-based intervention was developed in collaboration, guided by an interdisciplinary advisory board. The intervention consisted of an evidence-based tool (ie, "HIV-testing advice for primary care") to support GPs in provider-initiated HIV testing. A modified stepped-wedge design compare two different intervention levels: (1) online dissemination of the HIV-testing advice and (2) dissemination with additional group-level training. Both conditions were compared against a control condition with no intervention. The effect of the intervention was measured using Poisson regression for national surveillance data. The primary outcome was the number of HIV diagnoses made by GPs. Secondary outcomes were HIV diagnoses among groups at risk for undiagnosed HIV, distribution of new diagnoses by CD4 cell count, number of HIV tests prescribed by GPs, and rate of new diagnoses by tests. To evaluate the intervention's implementation, the GPs' fidelity to the intervention and the intervention's feasibility and acceptability by GPs were assessed through (web-based) surveys and in-depth telephone interviews.

Results: The study was funded in 2016 and ethically approved in January 2017. The implementation of the intervention started in January 2017 and ended in December 2018. Data was completed in October 2019 and was the starting point for the ongoing data analysis. The results are expected to be published in the second half of 2020.

Conclusions: Results of the intervention study will provide useful information on the intervention's effectiveness among Flemish GPs and can inform further development of official testing guidelines. Limitations of this real-life intervention approach are potential spill-over effects, delay in access to surveillance data, and little detailed information on HIV-testing practices among GPs.

VL - 9 CP - 8 M3 - 10.2196/16486 ER - TY - RPRT T1 - Epidémiologie du SIDA et de l'infection à VIH en Belgique. Situation au 31 décembre 2019. Y1 - 2020 A1 - Jessika Deblonde A1 - Dominique Van Beckhoven A1 - Marion Montourcy A1 - Maarten De Rouck KW - AIDS KW - épidémiologie KW - HIV PB - Sciensano CY - Bruxelles ER - TY - RPRT T1 - Epidemiologie van aids en hiv-infectie in België. Toestand op 31 december 2019. Y1 - 2020 A1 - Jessika Deblonde A1 - Dominique Van Beckhoven A1 - Marion Montourcy A1 - Maarten De Rouck A1 - André Sasse KW - AIDS KW - épidémiologie KW - HIV PB - Sciensano CY - Brussel ER - TY - JOUR T1 - Impact of solid cancer on in-hospital mortality overall and among different subgroups of patients with COVID-19: a nationwide, population-based analysis. JF - ESMO Open Y1 - 2020 A1 - Evandro de Azambuja A1 - Mariana Brandão A1 - Hans Wildiers A1 - Annouschka Laenen A1 - Sandrine Aspeslagh A1 - Christel Fontaine A1 - Joelle Collignon A1 - Willem Lybaert A1 - Jolanda Verheezen A1 - Annemie Rutten A1 - Peter Vuylsteke A1 - Jean-Charles Goeminne A1 - Wim Demey A1 - Dominique Van Beckhoven A1 - Jessika Deblonde A1 - Sylvie Rottey A1 - Tatjana Geukens A1 - Kevin Punie KW - Adrenal Cortex Hormones KW - Aged KW - Aged, 80 and over KW - Belgium KW - Betacoronavirus KW - comorbidity KW - Coronavirus Infections KW - COVID-19 KW - Female KW - Hospital Mortality KW - Hospitalization KW - Humans KW - intensive care units KW - Lung KW - Male KW - middle aged KW - Neoplasms KW - Pandemics KW - Pneumonia, Viral KW - Prognosis KW - Respiration, Artificial KW - Risk Factors KW - SARS-CoV-2 AB -

BACKGROUND: Cancer seems to have an independent adverse prognostic effect on COVID-19-related mortality, but uncertainty exists regarding its effect across different patient subgroups. We report a population-based analysis of patients hospitalised with COVID-19 with prior or current solid cancer versus those without cancer.

METHODS: We analysed data of adult patients registered until 24 May 2020 in the Belgian nationwide database of Sciensano. The primary objective was in-hospital mortality within 30 days of COVID-19 diagnosis among patients with solid cancer versus patients without cancer. Severe event occurrence, a composite of intensive care unit admission, invasive ventilation and/or death, was a secondary objective. These endpoints were analysed across different patient subgroups. Multivariable logistic regression models were used to analyse the association between cancer and clinical characteristics (baseline analysis) and the effect of cancer on in-hospital mortality and on severe event occurrence, adjusting for clinical characteristics (in-hospital analysis).

RESULTS: A total of 13 594 patients (of whom 1187 with solid cancer (8.7%)) were evaluable for the baseline analysis and 10 486 (892 with solid cancer (8.5%)) for the in-hospital analysis. Patients with cancer were older and presented with less symptoms/signs and lung imaging alterations. The 30-day in-hospital mortality was higher in patients with solid cancer compared with patients without cancer (31.7% vs 20.0%, respectively; adjusted OR (aOR) 1.34; 95% CI 1.13 to 1.58). The aOR was 3.84 (95% CI 1.94 to 7.59) among younger patients (<60 years) and 2.27 (95% CI 1.41 to 3.64) among patients without other comorbidities. Severe event occurrence was similar in both groups (36.7% vs 28.8%; aOR 1.10; 95% CI 0.95 to 1.29).

CONCLUSIONS: This population-based analysis demonstrates that solid cancer is an independent adverse prognostic factor for in-hospital mortality among patients with COVID-19. This adverse effect was more pronounced among younger patients and those without other comorbidities. Patients with solid cancer should be prioritised in vaccination campaigns and in tailored containment measurements.

VL - 5 CP - 5 M3 - 10.1136/esmoopen-2020-000947 ER - TY - JOUR T1 - Incidence rate, predictors and outcomes of interruption of HIV care: nationwide results from the Belgian HIV cohort JF - HIV Medicine Y1 - 2020 A1 - Dominique Van Beckhoven A1 - Florence, E A1 - De Wit, S A1 - Chloé Wyndham-Thomas A1 - A Sasse A1 - Herman Van Oyen A1 - J Macq KW - AIDS KW - HIV KW - HIV care KW - loss to follow-up KW - maintenance KW - re-engagement KW - retention KW - SIDA KW - VIH AB -

Objectives

We aimed to study the incidence rate, predictors and outcomes of HIV care interruption (HCI) in

Belgium.

Methods

We analysed data for adult patients with at least two HIV care records in the Belgian HIV cohort

between 1 January 2007 and 31 December 2016. An HCI episode was defined as 1 year without an

HIV care record. The HCI incidence rate was analysed using Poisson regression, return to HIV care

using a cumulative incidence function with death as a competing risk, and viral load (VL) status

upon return to HIV care using logistic regression.

Results

We included 16 066 patients accounting for 78 625 person-years of follow-up. The incidence rate

of HCI was 5.3/100 person-years [95% confidence interval (CI) 5.1 5.4/100 person-years]. The –

incidence of return to HIV care after HCI was estimated at 77.5% (95% CI 75.7 79.2%). Of those –

who returned to care, 43.7% had a VL ≤ 200 HIV-1 RNA copies/mL, suggesting care abroad or

suboptimal care (without an HIV-related care record) in Belgium during the HCI, and 56.3%

returned without controlled VL and were therefore considered as having experienced a real gap in

HIV care; they represented 2.3/100 person-years of follow-up. Factors individually associated with

HCI were no antiretroviral therapy (ART) uptake, lower age, injecting drug use, non-Belgian

nationality, male gender, not being a man who has sex with men, a shorter time since HIV

diagnosis, no high blood pressure and CD4 count < 350 cells/μL.

Conclusions

This study highlights the need to investigate return to care and viral status at return, to better

understand HCI. Identified predictors can help health care workers to target patients at higher risk

of HCI for awareness and support.

VL - 21 CP - 9 M3 - 10.1111/hiv.12901 ER - TY - RPRT T1 - Infection COVID-19 chez les enfants en Belgique. Résultats de la surveillance laboratoire, données scolaires et surveillance clinique des patients hospitalisés, 18/03-28/06/2020 Y1 - 2020 A1 - Laura Cornelissen A1 - Amber Litzroth A1 - Marion Montourcy A1 - Maarten De Rouck A1 - Chloé Wyndham-Thomas A1 - Sofieke Klamer A1 - Dominique Van Beckhoven AB -

Les enfants ne sont pas des “petits adultes” ; ils constituent un groupe distinct, différent de la population adulte tant physiquement que dans ses caractéristiques sociales, et qui mérite une attention particulière. Le présent rapport se focalise sur ce group spécifique et réunit des données provenant de plusieurs sources de données belges. Le nombre total de cas confirmés de COVID-19 chez les enfants est faible. Ceci a souvent été attribué au fait que les enfants sont moins testés, mais les données de laboratoires montrent que ce n’est que partiellement correct. Les enfants ont effectivement été moins testés : ils constituent 20 % de la population belge mais seulement 10 % du nombre total de tests réalisés. Mais même lorsque les enfants sont testés, le test est moins souvent positif que chez les adultes (1,8 % en moyenne contre 6,3 %). Le nombre de tests chez les enfants a été particulièrement faible au début de l’épidémie, lorsque les tests étaient réservés aux cas sévères. Après les changements apportés à la stratégie de testing le 4 mai (tous les cas possibles pouvant être testés) et le 11 juin (tous les contacts étroits d’un cas confirmé devant également être testés), nous avons observé une forte augmentation du nombre de tests réalisés chez les enfants. Pendant la majeure partie de la période décrite dans ce rapport, l’enseignement à distance était la règle, certainement pour les élèves des écoles secondaires. Au total, 378 cas ont été signalés en milieu scolaire, dont 270 élèves et 108 membres du personnel. Ces cas signalés dans les écoles ont eu pour conséquence la mise en quarantaine préventive de 4715 personnes (dont 243 adultes). Le nombre élevé de personnes en quarantaine est en contraste avec le nombre limité de cas secondaires rapportés : 11 membres du personnel (4,7 % des membres du personnel en quarantaine) et 36 élèves (0,8 % des 4 472 élèves en quarantaine) ont probablement été contaminés dans le cadre scolaire. La majorité des enfants testés positifs au SARS-CoV-2 n’ont pas dû être hospitalisés. Même s’ils constituaient 3 % du nombre de personnes ayant une infection confirmée, ils ne représentaient que 1,6 % du nombre total de patients hospitalisés pour le COVID-19. En outre, la grande partie (81 %) des hospitalisations chez les enfants se sont déroulées sans complications graves (telles que pneumonie, surinfection bactérienne ou fongique, hospitalisation en soins intensifs et syndrome de détresse respiratoire aiguë). La durée du séjour des enfants à l’hôpital était par conséquent généralement courte (médiane = 3 jours) et significativement moins longue que celle de l’ensemble des patients faisant partie de la surveillance hospitalière (médiane = 8 jours). Les plus jeunes enfants, à savoir les enfants de moins de 3 mois, représentent une grande partie de ces hospitalisations pédiatriques. Cela s’explique probablement par le fait que la fièvre chez ces jeunes enfants est un signal d’alarme menant rapidement à la réalisation d’un test diagnostique (ce qui augmente les chances de confirmation du diagnostic) et par le fait qu’un test positif dans cette tranche d’âge engendre une plus grande inquiétude (et entraînera donc une hospitalisation plus rapide). Malgré le fait que les jeunes enfants sont hospitalisés plus souvent, il semble, sur la base de nos données, que ce sont au contraire les groupes d’âge plus élevés (un an ou plus, comparé aux moins d’un an) qui sont à plus haut risque de présenter une évolution clinique sévère. Il est néanmoins possible que ces données soient biaisés par le fait que, comme expliqué plus haut, les jeunes enfants sont plus rapidement testés et hospitalisés.

ER - TY - JOUR T1 - Low-dose hydroxychloroquine therapy and mortality in hospitalised patients with COVID-19: a nationwide observational study of 8075 participants JF - International Journal of Antimicrobial Agents Y1 - 2020 A1 - Lucy Catteau A1 - Nicolas Dauby A1 - Marion Montourcy A1 - Bottieau, Emmanuel A1 - Joris Hautekiet A1 - Goetghebeur, Els A1 - Sabrina Van Ierssel A1 - Els Duysburgh A1 - Herman Van Oyen A1 - Chloé Wyndham-Thomas A1 - Dominique Van Beckhoven A1 - Kristof Bafort A1 - Leïla Belkhir A1 - Nathalie Bossuyt A1 - Philippe Caprasse A1 - Vincent Colombie A1 - De Munter, Paul A1 - Jessika Deblonde A1 - Didier Delmarcelle A1 - Mélanie Delvallee A1 - Demeester, Rémy A1 - Thierry Dugernier A1 - Xavier Holemans A1 - Benjamin Kerzmann A1 - Pierre Yves Machurot A1 - Philippe Minette A1 - Jean-Marc Minon A1 - Saphia Mokrane A1 - Catherine Nachtergal A1 - Séverine Noirhomme A1 - Piérard, Denis A1 - Camelia Rossi A1 - Schirvel, Carole A1 - Erica Sermijn A1 - Frank Staelens A1 - Filip Triest A1 - Nina Van Goethem A1 - Jens Van Praet A1 - Anke Vanhoenacker A1 - Roeland Verstraete A1 - Elise Willems KW - COVID-19 KW - Hydroxychloroquine KW - mortality KW - observational study KW - SARS-CoV-2 AB -

Hydroxychloroquine (HCQ) has been largely used and investigated as therapy for COVID-19 across various

settings at a total dose usually ranging from 2400 mg to 9600 mg. In Belgium, off-label use of

low-dose HCQ (total 2400 mg over 5 days) was recommended for hospitalised patients with COVID-19.

We conducted a retrospective analysis of in-hospital mortality in the Belgian national COVID-19 hospital

surveillance data. Patients treated either with HCQ monotherapy and supportive care (HCQ group) were

compared with patients treated with supportive care only (no-HCQ group) using a competing risks proportional

hazards regression with discharge alive as competing risk, adjusted for demographic and clinical

features with robust standard errors. Of 8075 patients with complete discharge data on 24 May 2020

and diagnosed before 1 May 2020, 4542 received HCQ in monotherapy and 3533 were in the no-HCQ

group. Death was reported in 804/4542 (17.7%) and 957/3533 (27.1%), respectively. In the multivariable

analysis, mortality was lower in the HCQ group compared with the no-HCQ group [adjusted hazard ratio

(aHR) = 0.684, 95% confidence interval (CI) 0.617–0.758]. Compared with the no-HCQ group, mortality

in the HCQ group was reduced both in patients diagnosed ≤5 days ( n = 3975) and > 5 days ( n = 3487)

after symptom onset [aHR = 0.701 (95% CI 0.617–0.796) and aHR = 0.647 (95% CI 0.525–0.797), respectively].

Compared with supportive care only, low-dose HCQ monotherapy was independently associated

with lower mortality in hospitalised patients with COVID-19 diagnosed and treated early or later after

symptom onset.

VL - 56 CP - 4 M3 - 10.1016/j.ijantimicag.2020.106144 ER - TY - JOUR T1 - Rapid establishment of a national surveillance of COVID-19 hospitalizations in Belgium JF - Archives of Public Health Y1 - 2020 A1 - Nina Van Goethem A1 - Aline Vilain A1 - Chloé Wyndham-Thomas A1 - Jessika Deblonde A1 - Nathalie Bossuyt A1 - Tinne Lernout A1 - Javiera Rebolledo A1 - Sophie Quoilin A1 - Vincent Melis A1 - Dominique Van Beckhoven VL - 78 CP - 1 M3 - 10.1186/s13690-020-00505-z ER - TY - JOUR T1 - Reply to 'Low-dose hydroxychloroquine therapy and lower mortality in hospitalized patients with COVID-19: association does not mean causality'. JF - Int J Antimicrob Agents Y1 - 2020 A1 - N Dauby A1 - Lucy Catteau A1 - Joris Hautekiet A1 - Marion Montourcy A1 - E Bottieau A1 - Goetghebeur, E A1 - Dominique Van Beckhoven M3 - 10.1016/j.ijantimicag.2020.106261 ER - TY - JOUR T1 - Time between Symptom Onset, Hospitalisation and Recovery or Death: Statistical Analysis of Belgian COVID-19 Patients. JF - Int J Environ Res Public Health Y1 - 2020 A1 - Faes, Christel A1 - Steven Abrams A1 - Dominique Van Beckhoven A1 - Geert Meyfroidt A1 - Vlieghe, Erika A1 - Hens, Niel KW - Adult KW - Aged KW - Belgium KW - Coronavirus Infections KW - COVID-19 KW - Data Interpretation, Statistical KW - Hospitalization KW - Humans KW - Length of Stay KW - middle aged KW - nursing homes KW - Pandemics KW - Pneumonia, Viral KW - Time-to-Treatment KW - Treatment Outcome KW - Young adult AB -

There are different patterns in the COVID-19 outbreak in the general population and amongst nursing home patients. We investigate the time from symptom onset to diagnosis and hospitalization or the length of stay (LoS) in the hospital, and whether there are differences in the population. Sciensano collected information on 14,618 hospitalized patients with COVID-19 admissions from 114 Belgian hospitals between 14 March and 12 June 2020. The distributions of different event times for different patient groups are estimated accounting for interval censoring and right truncation of the time intervals. The time between symptom onset and hospitalization or diagnosis are similar, with median length between symptom onset and hospitalization ranging between 3 and 10.4 days, depending on the age of the patient (longest delay in age group 20-60 years) and whether or not the patient lives in a nursing home (additional 2 days for patients from nursing home). The median LoS in hospital varies between 3 and 10.4 days, with the LoS increasing with age. The hospital LoS for patients that recover is shorter for patients living in a nursing home, but the time to death is longer for these patients. Over the course of the first wave, the LoS has decreased.

VL - 17 CP - 20 M3 - 10.3390/ijerph17207560 ER - TY - RPRT T1 - Epidémiologie du SIDA et de l'infection à VIH en Belgique. Situation au 31 décembre 2018. Y1 - 2019 A1 - André Sasse A1 - Jessika Deblonde A1 - Maarten De Rouck A1 - Marion Montourcy A1 - Dominique Van Beckhoven KW - épidémiologie KW - SIDA KW - VIH PB - Sciensano CY - Brussels ER - TY - RPRT T1 - Epidemiologie van aids en hiv-infectie in België. Toestand of 31 december 2018. Y1 - 2019 A1 - André Sasse A1 - Jessika Deblonde A1 - Maarten De Rouck A1 - Marion Montourcy A1 - Dominique Van Beckhoven KW - AIDS KW - épidémiologie KW - HIV PB - Sciensano CY - Brussels, Belgium ER - TY - JOUR T1 - Estimates of the HIV undiagnosed population in Belgium reveals higher prevalence for MSM with foreign nationality and for geographic areas hosting big cities JF - Journal of the International AIDS Society Y1 - 2019 A1 - Lise Marty A1 - Dominique Van Beckhoven A1 - Cloë Ost A1 - Jessika Deblonde A1 - Costagliola, Dominique A1 - André Sasse A1 - Supervie, Virginie A1 - Hanne Apers A1 - Anda Ķīvīte A1 - Loos, Jasna A1 - Nöstlinger, Christiana A1 - Daniela Rojas Castro KW - HIV KW - HIV prevalence KW - undiagnosed HIV infections AB -

Introduction: Increasing our knowledge on geographic areas and key populations most affected by HIV is essential to improve prevention and care and to ensure a more focused HIV response. Here, we estimated the prevalence of undiagnosed HIV infections in Belgium and its distribution across geographic areas and exposure groups.

Methods: We used surveillance data on newly diagnosed HIV cases and a previously developed back-calculation model to estimate number and prevalence rates (per 10000) of undiagnosed HIV infections by exposure group at national and subnational levels. Belgium consists of three regions: Flanders, Brussels-Capital Region and Wallonia. We produced estimates for Brussels-Capital Region and Wallonia. For Flanders, we produced estimates for two sub-regional areas: the province of Antwerp and the other provinces, because Antwerp is the second largest city after Brussels. Population sizes were determined using data from the Belgian Statistical Office and surveys on sexual behaviour and drug use.

Results: In Belgium, in 2015, an estimated 2818 (95% confidence interval: 2494 to 3208) individuals were living with undiagnosed HIV, that is, 15% of individuals living with HIV. The Brussels-Capital Region and the province of Antwerp, which host the two biggest cities, accounted for ~60% of the undiagnosed infections, and had the highest undiagnosed prevalence rates per 10000: 12.0 (9.4 to 15.3) and 7.4 (5.6 to 9.8) respectively. Individuals with foreign nationality accounted for 56% of the total number of undiagnosed infections, and were the most affected populations in all areas in terms of undiagnosed prevalence rates. Specifically, men who have sex with men (MSM) with non-European nationality were the most affected population in the province of Antwerp (853.4 (408.2 to 1641.9) undiagnosed infections per 10000), the Brussels-Capital Region (543.9 (289.1 to 1019.1)), and the other provinces of Flanders (691.7 (235.5 to 1442.2)), while in Wallonia, it was heterosexual women with Sub-Saharan African nationality (132.2 (90.6 to 178.5)).

Conclusions: Geographic areas hosting the biggest cities in Belgium accounted for the vast majority of undiagnosed HIV infections and individuals with foreign nationality were the most affected, especially MSM with non-European nationality. This should be accounted for when tailoring prevention and testing programs. Furthermore, MSM with foreign nationality require more attention in Belgium, and certainly more generally in Europe.

VL - 22 CP - 8 M3 - 10.1002/jia2.25371 ER - TY - JOUR T1 - Exploring HIV-1 Transmission Dynamics by Combining Phylogenetic Analysis and Infection Timing JF - Viruses Y1 - 2019 A1 - Verhofstede, Chris A1 - Virginie Mortier A1 - Kenny Dauwe A1 - S. Callens A1 - Jessika Deblonde A1 - Géraldine Dessilly A1 - Delforge, Marie-Luce A1 - Fransen, Katrien A1 - André Sasse A1 - Stoffels, Karolien A1 - Dominique Van Beckhoven A1 - Fien Vanroye A1 - Vaira, Dolorès A1 - Ellen Vancutsem A1 - Kristel Van Laethem KW - HIV KW - transmission dynamics KW - transmission networks AB -

HIV-1 pol sequences obtained through baseline drug resistance testing of patients newly diagnosed between 2013 and 2017 were analyzed for genetic similarity. For 927 patients the information on genetic similarity was combined with demographic data and with information on the recency of infection. Overall, 48.3% of the patients were genetically linked with 11.4% belonging to a pair and 36.9% involved in a cluster of ≥3 members. The percentage of early diagnosed (≤4 months after infection) was 28.6%. Patients of Belgian origin were more frequently involved in transmission clusters (49.7% compared to 15.3%) and diagnosed earlier (37.4% compared to 12.2%) than patients of Sub-Saharan African origin. Of the infections reported to be locally acquired, 69.5% were linked (14.1% paired and 55.4% in a cluster). Equal parts of early and late diagnosed individuals (59.9% and 52.4%, respectively) were involved in clusters. The identification of a genetically linked individual for the majority of locally infected patients suggests a high rate of diagnosis in this population. Diagnosis however is often delayed for >4 months after infection increasing the opportunities for onward transmission. Prevention of local infection should focus on earlier diagnosis and protection of the still uninfected members of sexual networks with human immunodeficiency virus (HIV)-infected members.

VL - 11 CP - 12 M3 - 10.3390/v11121096 ER - TY - RPRT T1 - Épidémiologie du sida et de l'infection à VIH en Belgique. Situation au 31 décembre 2017. Y1 - 2018 A1 - André Sasse A1 - Jessika Deblonde A1 - Jamine, David A1 - Dominique Van Beckhoven KW - Belgique KW - épidémiologie KW - SIDA KW - VIH AB -

Une diminution moins prononcée des nouveaux diagnostics de VIH en 2017
En 2017, le nombre de nouveaux diagnostics de VIH a diminué : moins 2 % par rapport à 2016 et moins 27,5 % depuis 2012. Sciensano a enregistré 890 nouveaux diagnostics en 2017, ce qui correspond à 2,4 nouveaux cas de VIH par jour en moyenne. Si, pour Sciensano, la poursuite de cette diminution est un signe encourageant, la vigilance reste toutefois de mise car le nombre de nouveaux cas de VIH diagnostiqués en Belgique reste globalement élevé. Il est donc nécessaire d’optimiser et intensifier l’utilisation de l’éventail d’interventions de prévention disponibles en Belgique.

Les principaux enseignements pour 2017
Sciensano a enregistré 890 nouveaux diagnostics en 2017, ce qui correspond à une diminution de 2% par rapport à 2015 et de 27.5% par rapport à 2012. 
La légère baisse observée concerne surtout les hommes ayant des relations sexuelles avec d’autres hommes.
La transmission lors de l’utilisation de drogues par voie intraveineuse est rarement rapportée, avec 1% seulement des diagnostics en 2017.

Les hommes ayant des relations sexuelles avec d’autres hommes
Le nombre de nouvelles infections diagnostiquées chez les hommes ayant des relations sexuelles avec d’autres hommes (HSH) a diminué de 34% par rapport à 2013, lorsque le pic chez les HSH fut atteint. 
Les diagnostics chez les HSH représentent actuellement 48.6% des nouvelles infections enregistrées pour lesquelles le mode de contamination est connu. Ces diagnostics concernent principalement des personnes de nationalité belge (63%), les autres nationalités européennes représentant 17% des diagnostics. Il s’agit en l’occurrence principalement de Néerlandais, de Français et d’Espagnols. 
La diminution des nouveaux diagnostics de VIH est observée chez les personnes de nationalité belge et chez les HSH ayant une autre nationalité.

Les femmes et les hommes contaminés par contacts hétérosexuels
Entre 2012 et 2017, le nombre de nouveaux diagnostics de VIH a diminué de 39% chez les hétérosexuels. En 2017, ils représentent 48.3% des nouveaux diagnostics pour lesquelles le mode de contamination est connu. Parmi les personnes hétérosexuelles diagnostiquées en 2017, 49% ont la nationalité d’un pays d’Afrique subsaharienne et 28% sont Belges. La baisse observée chez les hétérosexuels concerne plutôt les personnes originaires d’un pays d’Afrique sub-saharienne. Parmi les hétérosexuels belges, le nombre de nouveaux diagnostics est resté relativement stable entre 2008 et 2015; ensuite une diminution a également été observée.

Le dépistage du VIH et les diagnostics tardifs
Le nombre de tests de dépistage pour le VIH a légèrement diminué (-2%). En 2017, 63 tests VIH par 1000 habitants ont été réalisés et la proportion de nouveaux diagnostics est de 1,25 par 1000 tests.
36% des infections au VIH ont été diagnostiquées tardivement. Les diagnostics tardifs restent plus fréquents chez les hétérosexuels (46%) que chez les HSH (27%).

Personnes vivant avec le VIH
Le nombre de personnes vivant avec le VIH en Belgique en 2017 est estimé à 18 908 personnes, ce qui correspond à une prévalence de l’infection à VIH de 1,7 personnes par 1000 habitants. Parmi ces personnes, 16 849 personnes ont été diagnostiquées et 2059 n’ont pas encore été diagnostiquées. Ces personnes ignorant leur infection représentent 10,9% de la population vivant avec le VIH.

PB - Sciensano CY - Brussels SN - 1783-5178 ER - TY - RPRT T1 - Epidémiologie du VIH, Mise à jour - patients en suivi, 2016 Y1 - 2018 A1 - André Sasse A1 - Jessika Deblonde A1 - Jamine, David A1 - Cloë Ost A1 - Dominique Van Beckhoven ER - TY - RPRT T1 - Epidemiologie van aids en hiv-infectie in België. Toestand op 31 december 2017. Y1 - 2018 A1 - André Sasse A1 - Jessika Deblonde A1 - Jamine, David A1 - Dominique Van Beckhoven KW - AIDS KW - Belgium KW - epidemiology KW - HIV AB -

Een minder uitgesproken daling van het aantal hiv-diagnoses in 2017 
In 2017 daalde het aantal nieuwe hiv-diagnoses met 2% in vergelijking met 2016 en met 27.5% in vergelijking met 2012. Sciensano registreerde 890 gediagnosticeerde hiv-infecties in 2017 wat overeenstemt met gemiddeld 2.4 nieuwe diagnoses per dag. De verderzetting van de dalende trend is voor Sciensano een bemoedigend teken. Toch blijft waakzaamheid geboden omdat het aantal nieuwe hiv-diagnoses hoog blijft. Dit vraagt om een nog intensiever gebruik van de preventieve interventies die in België beschikbaar zijn.

De belangrijkste bevindingen van het rapport 2017
Sciensano registreerde 890 gediagnosticeerde hiv-infecties in 2017 wat overeenstemt met een daling van 2% in vergelijking met 2016 en met 27.5% in vergelijking met 2012. 
De geobserveerde lichte daling in 2017 betreft hoofdzakelijk mannen die seks hebben met mannen (MSM).
De overdracht via intraveneus drugsgebruik is uitzonderlijk in België, en werd slechts voor 1% van de hiv-diagnoses in 2017 gerapporteerd.

Mannen die seks hebben met mannen
Het aantal nieuwe hiv-diagnoses bij mannen die seks hebben met mannen (MSM) daalde met 34% in vergelijking met 2013 toen de hoogste piek werd waargenomen. 
In 2017 vertegenwoordigden de diagnoses bij MSM, 48.6% van de nieuwe geregistreerde hiv-infecties waarvan de overdrachtswijze gekend is. Deze diagnoses werden voornamelijk bij Belgen (63%) vastgesteld, terwijl de personen met een andere Europese nationaliteit 17% van de diagnoses vertegenwoordigden. Het betreft voornamelijk Nederlanders, Fransen en Spanjaarden.
De daling van het aantal hiv-diagnoses deed zich voor zowel bij MSM met de Belgische nationaliteit als bij MSM met een andere nationaliteit.

Heteroseksuele mannen en vrouwen
Tussen 2012 en 2017 daalde het aantal nieuwe hiv-diagnoses bij heteroseksuelen met 39%.
In 2017 vertegenwoordigden deze diagnoses 48.3% van de nieuw geregistreerde hiv-infecties waarvan de overdrachtswijze gekend is. Van de gediagnosticeerde heteroseksuelen, was 49% afkomstig van Sub-Saharaans Afrika en was 28% Belg. 
De geobserveerde daling bij de heteroseksuelen kan hoofdzakelijk toegeschreven worden aan de daling van het aantal diagnoses in de populatie afkomstig van Sub-Saharaans Afrika. Bij heteroseksuele Belgen bleef het aantal nieuwe diagnoses tussen 2008 en 2015 vrij stabiel; daarna werd een daling waargenomen.

Opsporing van hiv en laattijdige diagnoses
In 2017 was er een lichte daling met 2% van het aantal opsporingstests voor hiv. Er werden 63 hiv-tests per 1000 inwoners uitgevoerd en per 1000 uitgevoerde tests werden 1,25 nieuwe diagnoses vastgesteld.
Zesendertig procent van de hiv-infecties werd laattijdig vastgesteld. Laattijdige diagnoses komen nog steeds vaker voor bij heteroseksuelen (46%) dan bij MSM (27%).

Personen die met hiv leven
Het aantal personen dat in België met hiv leefde in 2017, wordt geschat op 18 908. Dit komt overeen met een hiv-prevalentie van 1.7 personen per 1000 inwoners. In 2017 waren 16 849 personen onder hen al gediagnosticeerd en 2059 waren nog niet gediagnosticeerd. Van al de personen die met hiv leven, was 10.9% zich dus niet bewust van zijn of haar serostatus.

PB - Sciensano CY - Brussels, Belgium SN - 1783-4988 M3 - https://doi.org/10.25608/NBWP-GJ70 ER - TY - RPRT T1 - Epidemiologie van HIV. Update - patiënten in opvolging, 2016 Y1 - 2018 A1 - Dominique Van Beckhoven A1 - Jamine, David A1 - André Sasse KW - AIDS KW - HIV PB - Wetenschappelijk Instituut Volksgezondheid (WIV-ISP) CY - Brussel, België ER - TY - RPRT T1 - Epidemiologische suveillance van mycoses (2015) Y1 - 2018 A1 - Dominique Van Beckhoven A1 - Cloë Ost A1 - Rosalie Sacheli A1 - Sofie Patteet A1 - Marie-Pierre Hayette A1 - Lagrou, Katrien KW - Mycoses PB - Wetenschappelijk Instituut Volksgezondheid CY - Brussel, België ER - TY - JOUR T1 - Health and budget impact of combined HIV prevention - first results of the BELHIVPREV model. JF - Acta Clin Belg Y1 - 2018 A1 - Vermeersch, Sebastian A1 - S. Callens A1 - De Wit, Stéphane A1 - Goffard, Jean-Christophe A1 - Laga, Marie A1 - Dominique Van Beckhoven A1 - Annemans, Lieven KW - Anti-Retroviral Agents KW - Belgium KW - Female KW - HIV Infections KW - Humans KW - Male KW - Models, Economic AB -

OBJECTIVES: We developed a pragmatic modelling approach to estimate the impact of treatment as prevention (TasP); outreach testing strategies; and pre-exposure prophylaxis (PrEP) on the epidemiology of HIV and its associated pharmaceutical expenses.

METHODS: Our model estimates the incremental health (in terms of new HIV diagnoses) and budget impact of two prevention scenarios (outreach+TasP and outreach+TasP+PrEP) against a 'no additional prevention' scenario. Model parameters were estimated from reported Belgian epidemiology and literature data. The analysis was performed from a healthcare payer perspective with a 15-year-time horizon. It considers subpopulation differences, HIV infections diagnosed in Belgium having occurred prior to migration, and the effects of an ageing HIV population.

RESULTS: Without additional prevention measures, the annual number of new HIV diagnoses rises to over 1350 new diagnoses in 2030 as compared to baseline, resulting in a budget expenditure of €260.5 million. Implementation of outreach+TasP and outreach+TasP+PrEP results in a decrease in the number of new HIV diagnoses to 865 and 663 per year, respectively. Respective budget impacts decrease by €20.6 million and €33.7 million.

CONCLUSION: Foregoing additional investments in prevention is not an option. An approach combining TasP, outreach and PrEP is most effective in reducing the number of new HIV diagnoses and the HIV treatment budget. Our model is the first pragmatic HIV model in Belgium estimating the consequences of a combined preventive approach on the HIV epidemiology and its economic burden assuming other prevention efforts such as condom use and harm reduction strategies remain the same.

VL - 73 CP - 1 U1 - https://www.ncbi.nlm.nih.gov/pubmed/28673201?dopt=Abstract M3 - 10.1080/17843286.2017.1339978 ER - TY - JOUR T1 - HIV testing within general practices in Europe: a mixed-methods systematic review. JF - BMC Public Health Y1 - 2018 A1 - Jessika Deblonde A1 - Dominique Van Beckhoven A1 - Loos, Jasna A1 - Nicole Boffin A1 - André Sasse A1 - Nöstlinger, Christiana A1 - Supervie, Virginie KW - Europe KW - General practice KW - general practitioners KW - HIV Infections KW - Humans KW - Mass Screening KW - Primary Health Care KW - Randomized Controlled Trials as Topic AB -

BACKGROUND: Late diagnosis of HIV infection remains a key challenge in Europe. It is acknowledged that general practitioners (GPs) may contribute greatly to early case finding, yet there is evidence that many diagnostic opportunities are being missed. To further promote HIV testing in primary care and to increase the utility of available research, the existing evidence has been synthesised in a systematic review adhering to the PRISMA guidelines.

METHODS: The databases PubMed, Scopus and Embase were searched for the period 2006-2017. Two authors judged independently on the eligibility of studies. Through a mixed-methods systematic review of 29 studies, we provide a description of HIV testing in general practices in Europe, including barriers and facilitators.

RESULTS: The findings of the study show that although various approaches to target patients are used by GPs, most tests are still carried out based on the patient's request. Several barriers obstruct HIV testing in general practice. Included are a lack of communication skills on sexual health, lack of knowledge about HIV testing recommendations and epidemic specificities, difficulties with using the complete list of clinical HIV indicator diseases and lack of experience in delivering and communicating test results. The findings also suggest that the provision of specific training, practical tools and promotion programmes has an impact on the testing performance of GPs.

CONCLUSIONS: GPs could have an increased role in provider-initiated HIV-testing for early case finding. To achieve this objective, solutions to the reported barriers should be identified and testing criteria adapted to primary healthcare defined. Providing guidance and training to better identify priority groups for HIV testing, as well as information on the HIV epidemic's characteristics, will be fundamental to increasing awareness and testing by GPs.

VL - 18 CP - 1 M3 - 10.1186/s12889-018-6107-0 ER - TY - JOUR T1 - Phylogenetic analysis of the Belgian HIV-1 epidemic reveals that local transmission is almost exclusively driven by men having sex with men despite presence of large African migrant communities JF - Infection, Genetics and Evolution Y1 - 2018 A1 - Verhofstede, Chris A1 - Kenny Dauwe A1 - Fransen, Katrien A1 - Kristel Van Laethem A1 - Van den Wijngaert, Sigi A1 - Jean Ruelle A1 - Delforge, Marie-Luce A1 - Ellen Vancutsem A1 - Vaira, Dolorès A1 - Stoffels, Karolien A1 - Sergio Garcia Ribas A1 - Géraldine Dessilly A1 - Laurent Debaisieux A1 - Piérard, Denis A1 - Van Ranst, Marc A1 - Marie-Pierre Hayette A1 - Jessika Deblonde A1 - André Sasse A1 - Dominique Van Beckhoven A1 - Virginie Mortier KW - AIDS KW - HIV KW - phylogenetics VL - 61 M3 - 10.1016/j.meegid.2018.03.002 ER - TY - JOUR T1 - Phylogenetic analysis of the Belgian HIV-1 epidemic reveals that local transmission is almost exclusively driven by men having sex with men despite presence of large African migrant communities. JF - Infect Genet Evol Y1 - 2018 A1 - Verhofstede, Chris A1 - Kenny Dauwe A1 - Fransen, Katrien A1 - Kristel Van Laethem A1 - Van den Wijngaert, Sigi A1 - Jean Ruelle A1 - Delforge, Marie-Luce A1 - Ellen Vancutsem A1 - Vaira, Dolorès A1 - Stoffels, Karolien A1 - Sergio Garcia Ribas A1 - Géraldine Dessilly A1 - Laurent Debaisieux A1 - Piérard, Denis A1 - Van Ranst, Marc A1 - Marie-Pierre Hayette A1 - Jessika Deblonde A1 - André Sasse A1 - Dominique Van Beckhoven A1 - Virginie Mortier AB -

To improve insight in the drivers of local HIV-1 transmission in Belgium, phylogenetic, demographic, epidemiological and laboratory data from patients newly diagnosed between 2013 and 2015 were combined and analyzed. Characteristics of clustered patients, paired patients and patients on isolated branches in the phylogenetic tree were compared. The results revealed an overall high level of clustering despite the short time frame of sampling, with 47.6% of all patients having at least one close genetic counterpart and 36.6% belonging to a cluster of 3 or more individuals. Compared to patients on isolated branches, patients in clusters more frequently reported being infected in Belgium (95.1% vs. 47.6%; p < 0.001), were more frequently men having sex with men (MSM) (77.9% vs. 42.8%; p < 0.001), of Belgian origin (68.2% vs. 32.9%; p < 0.001), male gender (92.6% vs. 65.8%; p < 0.001), infected with subtype B or F (87.8% vs. 43.4%; p < 0.001) and diagnosed early after infection (55.4% vs. 29.0%; p < 0.001). Strikingly, Sub-Saharan Africans (SSA), overall representing 27.1% of the population were significantly less frequently found in clusters than on individual branches (6.0% vs. 41.8%; p < 0.001). Of the SSA that participated in clustered transmission, 66.7% were MSM and this contrasts sharply with the overall 12.0% of SSA reporting MSM. Transmission clusters with SSA were more frequently non-B clusters than transmission clusters without SSA (44.4% versus 18.2%). MSM-driven clusters with patients of mixed origin may account, at least in part, for the increasing spread of non-B subtypes to the native MSM population, a cross-over that has been particularly successful for subtype F and CRF02_AG. The main conclusions from this study are that clustered transmission in Belgium remains almost exclusively MSM-driven with very limited contribution of SSA. There were no indications for local ongoing clustered transmission of HIV-1 among SSA.

VL - 61 M3 - 10.1016/j.meegid.2018.03.002 ER - TY - RPRT T1 - Surveillance épidémiologique des mycoses (2015) Y1 - 2018 A1 - Dominique Van Beckhoven A1 - Cloë Ost A1 - Rosalie Sacheli A1 - Sofie Patteet A1 - Marie-Pierre Hayette A1 - Lagrou, Katrien KW - Mycoses PB - Institut Scientifique de Santé Publique CY - Bruxelles, Belgique ER - TY - RPRT T1 - Epidémiologie du Sida et de l'infection à VIH en Belgique. Situation au 31 décembre 2016 Y1 - 2017 A1 - André Sasse A1 - Jessika Deblonde A1 - Jamine, David A1 - Cloë Ost A1 - Dominique Van Beckhoven ER - TY - JOUR T1 - The Human Immunodeficiency Virus Continuum of Care in European Union Countries in 2013: Data and Challenges. JF - Clin Infect Dis Y1 - 2017 A1 - Gourlay, Annabelle A1 - Noori, Teymur A1 - Pharris, Anastasia A1 - Axelsson, Maria A1 - Costagliola, Dominique A1 - Cowan, Susan A1 - Croxford, Sara A1 - d'Arminio Monforte, Antonella A1 - Del Amo, Julia A1 - Delpech, Valerie A1 - Díaz, Asunción A1 - Girardi, Enrico A1 - Gunsenheimer-Bartmeyer, Barbara A1 - Hernando, Victoria A1 - Jose, Sophie A1 - Leierer, Gisela A1 - Nikolopoulos, Georgios A1 - Obel, Niels A1 - Op de Coul, Eline A1 - Paraskeva, Dimitra A1 - Reiss, Peter A1 - Sabin, Caroline A1 - André Sasse A1 - Schmid, Daniela A1 - Sonnerborg, Anders A1 - Spina, Alexander A1 - Suligoi, Barbara A1 - Supervie, Virginie A1 - Touloumi, Giota A1 - Dominique Van Beckhoven A1 - van Sighem, Ard A1 - Vourli, Georgia A1 - Zangerle, Robert A1 - Porter, Kholoud KW - Anti-HIV Agents KW - Antiretroviral Therapy, Highly Active KW - Cohort Studies KW - Continuity of Patient Care KW - Disease Eradication KW - European Union KW - Female KW - HIV KW - HIV Infections KW - Humans KW - Male KW - Mass Screening KW - prevalence KW - United Nations KW - World Health Organization AB -

BACKGROUND.: The Joint United Nations Programme on HIV/AIDS (UNAIDS) has set a "90-90-90" target to curb the human immunodeficiency virus (HIV) epidemic by 2020, but methods used to assess whether countries have reached this target are not standardized, hindering comparisons.

METHODS.: Through a collaboration formed by the European Centre for Disease Prevention and Control (ECDC) with European HIV cohorts and surveillance agencies, we constructed a standardized, 4-stage continuum of HIV care for 11 European Union countries for 2013. Stages were defined as (1) number of people living with HIV in the country by end of 2013; (2) proportion of stage 1 ever diagnosed; (3) proportion of stage 2 that ever initiated ART; and (4) proportion of stage 3 who became virally suppressed (≤200 copies/mL). Case surveillance data were used primarily to derive stages 1 (using back-calculation models) and 2, and cohort data for stages 3 and 4.

RESULTS.: In 2013, 674500 people in the 11 countries were estimated to be living with HIV, ranging from 5500 to 153400 in each country. Overall HIV prevalence was 0.22% (range, 0.09%-0.36%). Overall proportions of each previous stage were 84% diagnosed, 84% on ART, and 85% virally suppressed (60% of people living with HIV). Two countries achieved ≥90% for all stages, and more than half had reached ≥90% for at least 1 stage.

CONCLUSIONS.: European Union countries are nearing the 90-90-90 target. Reducing the proportion undiagnosed remains the greatest barrier to achieving this target, suggesting that further efforts are needed to improve HIV testing rates. Standardizing methods to derive comparable continuums of care remains a challenge.

VL - 64 CP - 12 U1 - https://www.ncbi.nlm.nih.gov/pubmed/28369283?dopt=Abstract M3 - 10.1093/cid/cix212 ER - TY - RPRT T1 - Zoönosen en vectoroverdraagbare ziekten. Jaarrapport 2015-2016 Y1 - 2017 A1 - Javiera Rebolledo A1 - Amber Litzroth A1 - Katrien Tersago A1 - Dominique Van Beckhoven A1 - Tinne Lernout ER - TY - RPRT T1 - Zoonoses et maladies à transmission vectorielle. Surveillance épidémiologique en Belgique, 2015-2016 Y1 - 2017 A1 - Javiera Rebolledo A1 - Amber Litzroth A1 - Katrien Tersago A1 - Dominique Van Beckhoven A1 - Tinne Lernout ER - TY - RPRT T1 - Épidémiologie du SIDA et de l'infection à VIH en Belgique. Situation au 31 décembre 2015. Y1 - 2016 A1 - André Sasse A1 - Jamine, David A1 - Cloë Ost A1 - Dominique Van Beckhoven KW - 2015 KW - Belgique KW - épidémiologie KW - infections KW - SIDA KW - VIH PB - WIV-ISP CY - Bruxelles, Belgique SN - 1783-5178 ER - TY - RPRT T1 - Epidémiologie du SIDA et de l'infection à VIH en Belgique. Situation au 31 Décembre 2015 Y1 - 2016 A1 - André Sasse A1 - Jessika Deblonde A1 - Jamine, D A1 - Cloë Ost A1 - Dominique Van Beckhoven KW - AIDS KW - HIV PB - Institut Scientifique de Santé Publique (WIV-ISP) CY - Brussels ER - TY - RPRT T1 - Epidemiologie van AIDS en HIV-infectie in België. Toestand op 31 december 2015. Y1 - 2016 A1 - André Sasse A1 - Jamine, David A1 - Cloë Ost A1 - Dominique Van Beckhoven KW - 2015 KW - AIDS KW - België KW - épidémiologie KW - HIV KW - infecties PB - WIV-ISP CY - Brussel, België SN - 1783-4988 ER - TY - RPRT T1 - Epidemiologie van aids en hiv-infectie in België. Toestand op 31 december 2015. Y1 - 2016 A1 - André Sasse A1 - Jessika Deblonde A1 - Jamine, David A1 - Cloë Ost A1 - Dominique Van Beckhoven KW - AIDS KW - cohorte KW - diagnoses KW - HIV KW - Surveillance PB - WIV-ISP CY - Brussel, België ER - TY - RPRT T1 - Zoönosen en vectoroverdraagbare ziekten. Samenvattend jaaroverzicht 2015 Y1 - 2016 A1 - Javiera Rebolledo A1 - Tinne Lernout A1 - Amber Litzroth A1 - Dominique Van Beckhoven A1 - Bernard Brochier A1 - Delaere, B A1 - David Fretin A1 - Hing,M. A1 - Jacobs,J.A. A1 - B Kabamba Mukadi A1 - Marcella Mori A1 - Patteet,S. A1 - Saegeman,V. A1 - Vanessa Suin A1 - Truyens,C. A1 - Vanrompay, D A1 - Van Esbroeck, Marjan A1 - Steven Van Gucht A1 - P Wattiau KW - 2015 KW - Surveillance KW - vectoroverdraagbare ziekten KW - zoonosen PB - WIV-ISP CY - Brussel, België ER - TY - RPRT T1 - Zoonoses et maladies à transmission vectorielle. Surveillance épidémiologique en Belgique - Synthèse annuelle 2015 Y1 - 2016 A1 - Javiera Rebolledo A1 - Tinne Lernout A1 - Amber Litzroth A1 - Dominique Van Beckhoven A1 - Bernard Brochier A1 - Delaere,B. A1 - David Fretin A1 - Hing,M. A1 - B Kabamba Mukadi A1 - Marcella Mori A1 - Patteet,S. A1 - Saegeman,V. A1 - Vanessa Suin A1 - Truyens,C. A1 - Vanrompay, D A1 - Van Esbroeck, Marjan A1 - Steven Van Gucht A1 - P Wattiau KW - 2015 KW - Belgique KW - maladies à transmission vectorielle KW - Surveillance KW - Zoonoses PB - WIV-ISP CY - Bruxelles, Belgique ER - TY - RPRT T1 - Épidémiologie du SIDA et de l'infection à VIH en Belgique. Situation au 31 décembre 2014. Y1 - 2015 A1 - André Sasse A1 - Dominique Van Beckhoven KW - 2014 KW - Belgique KW - épidémiologie KW - infections KW - SIDA KW - VIH PB - WIV-ISP CY - Bruxelles, Belgique SN - 2466-7099 ER - TY - RPRT T1 - Epidemiologie van AIDS en HIV-infectie in België. Toestand op 31 december 2014. Y1 - 2015 A1 - André Sasse A1 - Dominique Van Beckhoven KW - 2014 KW - AIDS KW - België KW - épidémiologie KW - HIV KW - infecties PB - WIV-ISP CY - Brussel, België SN - 2466-7080 ER - TY - JOUR T1 - Good continuum of HIV care in Belgium despite weaknesses in retention and linkage to care among migrants JF - BMC Infectious Diseases Y1 - 2015 A1 - Dominique Van Beckhoven A1 - E. Florence A1 - J. Ruelle A1 - Jessika Deblonde A1 - C. Verhofstede A1 - S. Callens A1 - E. Vancutsem A1 - P. Lacor A1 - R. Demeester A1 - J.-C. Goffard A1 - André Sasse KW - AIDS KW - care KW - continuum of care KW - HIV VL - 15 CP - 1 M3 - 10.1186/s12879-015-1230-3 ER - TY - RPRT T1 - Zoönosen en Vector-Overdraagbare Ziekten. Epidemiologische surveillance in België, 2013 en 2014 Y1 - 2015 A1 - Javiera Rebolledo A1 - Tinne Lernout A1 - Amber Litzroth A1 - Dominique Van Beckhoven A1 - Bernard Brochier A1 - Delaere,B. A1 - David Fretin A1 - Heuninckx,W. A1 - Hing,M. A1 - Jacobs, J. A1 - B Kabamba Mukadi A1 - Maes,P. A1 - Marcella Mori A1 - Patteet,S. A1 - Sophie Quoilin A1 - Saegeman,V. A1 - Vanessa Suin A1 - Truyens,C. A1 - Vanrompay, D A1 - M. Van Esbroeck A1 - Steven Van Gucht A1 - P Wattiau KW - 2013 KW - 2014 KW - jaarrapport KW - overdraagbare ziekten KW - Vector KW - zoonosen PB - WIV-ISP CY - Brussel, België ER - TY - RPRT T1 - Zoonoses et maladies à transmission vectorielle. Surveillance épidémiologique en Belgique, 2013 et 2014 Y1 - 2015 A1 - Javiera Rebolledo A1 - Tinne Lernout A1 - Amber Litzroth A1 - Dominique Van Beckhoven A1 - Bernard Brochier A1 - Delaere,B. A1 - David Fretin A1 - Heuninckx,W. A1 - Hing,M. A1 - Jacobs,J.A. A1 - B Kabamba Mukadi A1 - Maes,P. A1 - Marcella Mori A1 - Patteet,S. A1 - Sophie Quoilin A1 - Saegeman,V. A1 - Vanessa Suin A1 - Truyens,C. A1 - Vanrompay, D A1 - Van Esbroeck, Marjan A1 - Steven Van Gucht A1 - P Wattiau KW - 2013 KW - 2014 KW - maladies à transmission vectorielle KW - Surveillance KW - Zoonoses PB - WIV-ISP CY - Bruxelles, Belgique ER - TY - RPRT T1 - Épidémiologie du SIDA et de l'infection à VIH en Belgique. Situation au 31 décembre 2013. Y1 - 2014 A1 - André Sasse A1 - Dominique Van Beckhoven KW - 2013 KW - Belgique KW - épidémiologie KW - infections KW - SIDA KW - VIH PB - WIV-ISP CY - Bruxelles, Belgique ER - TY - RPRT T1 - Epidemiologie van AIDS en HIV-infectie in België. Toestand op 31 december 2013. Y1 - 2014 A1 - André Sasse A1 - Dominique Van Beckhoven KW - 2013 KW - AIDS KW - België KW - épidémiologie KW - HIV KW - infecties PB - WIV-ISP CY - Brussel, België ER - TY - JOUR T1 - Factors associated with the continuum of care of HIV-infected patients in Belgium. JF - J Int AIDS Soc Y1 - 2014 A1 - Dominique Van Beckhoven A1 - Lacor, Patrick A1 - Moutschen, Michel A1 - Piérard, Denis A1 - André Sasse A1 - Vaira, Dolorès A1 - Van den Wijngaert, Sigi A1 - Vandercam, Bernard A1 - Van Ranst, Marc A1 - Van Wijngaerden, Eric A1 - Vandekerckhove, Linos A1 - Verhofstede, Chris A1 - Verbrugge, Ruth A1 - Demeester, Rémy A1 - De Wit, Stéphane A1 - Florence, Eric A1 - Fransen, Katrien A1 - Delforge, Marie-Luce A1 - Goffard, Jean-Christophe A1 - Goubau, Patrick AB -

INTRODUCTION: We studied factors associated with the continuum of HIV care in Belgium.

METHODS: Data of the national registration of new HIV diagnosis and of the national cohort of HIV-infected patients in care were combined to obtain estimates of and factors related with proportions of HIV-infected patients in each step of the continuum of care from diagnosis to suppressed viral load (VL). Factors associated with ignorance of HIV seropositivity were analyzed among patients co-infected with HIV and STI in the Belgian STI sentinel surveillance network. Associated factors were identified by multivariate logistic regression.

RESULTS: Among 4038 individuals diagnosed with HIV between 2007 and 2010, 90.3% were linked to care. Of 11684 patients in care in 2010, 90.8% were retained in care up to the following year, 88.3% of those were on ART, of whom 95.3% had suppressed VL (<500 cp/ml) (Figure 1). In multivariate analyses, factors associated with ignoring HIV+ status were being younger (p<0.001), being heterosexual compared to MSM, and of a region of origin other than Belgium, Sub-Saharan Africa and Europe. Non-Belgian regions of origin were associated with lower entry and retention in care (p<0.001 for both). Preoperative HIV testing was associated with lower entry in care (p=0.003). MSM had a higher retention in care (p<0.001), whilst IDU had lower retention (p=0.004). Low CD4 at first clinical contact and clinical reasons for HIV testing were independently associated with being on ART (p<0.001 for both); whilst prenatal HIV diagnosis was associated with lower proportion on ART (p=0.016) and lower proportion with suppressed VL among those on ART (p=0.005). Older age was associated with both being on ART and having suppressed VL among those on ART (p=0.007 and p<0.001 respectively), independently of time since HIV diagnosis (Table 1).

CONCLUSIONS: Regions of origin and risk groups (MSM/heterosexual/IDU) are the main factors associated with ignorance of HIV seropositivity, entry and retention in care, but once the HIV patient is retained in care, no effect of these factors on the proportions on ART and with suppressed VL are observed. The association of prenatal HIV diagnosis and proportions on ART and with suppressed VL could be biased by transitory CD4 disturbances during pregnancy and ART discontinuation after pregnancy. The higher probabilities of older patients to be on ART and have suppressed VL once retained in care could be influenced by factors not studied here like comorbidities, adherence or duration on ART.

VL - 17 CP - 4 Suppl 3 U1 - http://www.ncbi.nlm.nih.gov/pubmed/25394043?dopt=Abstract M3 - 10.7448/IAS.17.4.19534 ER - TY - RPRT T1 - Épidémiologie du SIDA et de l'infection à VIH en Belgique. Situation au 31 décembre 2012. Y1 - 2013 A1 - André Sasse A1 - Dominique Van Beckhoven KW - 2012 KW - Belgique KW - épidémiologie KW - infections KW - SIDA KW - VIH PB - WIV-ISP CY - Bruxelles, Belgique ER - TY - RPRT T1 - Epidemiologie van AIDS en HIV-infectie in België. Toestand op 31 december 2012. Y1 - 2013 A1 - André Sasse A1 - Dominique Van Beckhoven KW - 2012 KW - AIDS KW - België KW - épidémiologie KW - HIV KW - infecties PB - WIV-ISP CY - Brussel, België ER - TY - RPRT T1 - Épidémiologie du SIDA et de l'infection à VIH en Belgique. Situation au 31 décembre 2011. Y1 - 2012 A1 - André Sasse A1 - Verbrugge, Ruth A1 - Dominique Van Beckhoven KW - 2011 KW - Belgique KW - épidémiologie KW - infections KW - SIDA KW - VIH PB - WIV-ISP CY - Bruxelles, Belgique ER - TY - RPRT T1 - Epidemiologie du SIDA et de l'infection à VIH en Belgique. Situation au 31 décembre 2011 Y1 - 2012 A1 - André Sasse A1 - Verbrugge,R. A1 - Dominique Van Beckhoven KW - Belgique KW - de KW - SIDA KW - situation KW - VIH PB - WIV-ISP CY - Bruxelles SN - D/2012/2505/71 U1 - 33828 U2 - 2012/36 ER - TY - RPRT T1 - Epidemiologie van AIDS en HIV-infectie in België. Toestand op 31 december 2011. Y1 - 2012 A1 - André Sasse A1 - Verbrugge, Ruth A1 - Dominique Van Beckhoven KW - 2011 KW - AIDS KW - België KW - épidémiologie KW - HIV KW - infecties PB - WIV-ISP CY - Brussel, België ER - TY - RPRT T1 - Epidemiologie van AIDS en HIV-infectie in België. Toestand op 31 december 2011 Y1 - 2012 A1 - André Sasse A1 - Verbrugge,R. A1 - Dominique Van Beckhoven KW - België PB - WIV-ISP CY - Brussel SN - D/2012/2505/72 U1 - 33829 U2 - 2012/37 ER - TY - JOUR T1 - A national cohort of HIV-infected patients in Belgium: design and main characteristics. JF - Acta Clin Belg Y1 - 2012 A1 - Dominique Van Beckhoven A1 - Buvé, A A1 - Ruelle, J A1 - Seyler, L A1 - A Sasse KW - ADOLESCENT KW - Adult KW - Age Distribution KW - Aged KW - Belgium KW - Child KW - Child, Preschool KW - Female KW - Follow-Up Studies KW - HIV KW - HIV Infections KW - Humans KW - incidence KW - Infant KW - Infant, Newborn KW - Male KW - middle aged KW - Population Surveillance KW - Retrospective Studies KW - Risk Assessment KW - Risk Factors KW - Sex Distribution KW - Young adult AB -

In Belgium, individual laboratory and treatment data of all HIV-infected patients seen in the 9 AIDS Reference Centres and 7 AIDS Reference Laboratories are collected prospectively since 2006. We present here an analysis of patients recorded in the cohort database between 1st of January 2006 and 31st of December 2008. During that period, 11982 patients were under medical follow-up in Belgium. Sixty-one percent of the patients were male and the median age was 39.8 at the time of first recorded viral load. Among the patients whose nationality or probable mode of transmission was recorded, nearly half (48.0%) were Belgian and 38.3% originated from Sub-Saharan Africa; heterosexual contacts were reported in the majority of cases (56.0%) followed by homosexual contacts (35.3%). A total of 145 deaths were reported. Around three quarters of the patients were on ART. The median CD4 cell count rose from 470 cells/mm3 in 2006 to 501 cells/mm3 in 2008. This cohort enabled us to obtain comprehensive information on the numbers and characteristics of HIV-infected patients currently being followed up in Belgium, and on trends in antiretroviral therapy and biological results. This will serve for planning purposes, evaluation of access to care and as a source of information for further studies.

VL - 67 CP - 5 U1 - https://www.ncbi.nlm.nih.gov/pubmed/23189540?dopt=Abstract M3 - 10.2143/ACB.67.5.2062686 ER - TY - RPRT T1 - Epidemiologie du SIDA et de l'infection à VIH en Belgique. Situation au 31 décembre 2010 Y1 - 2011 A1 - André Sasse A1 - Verbrugge,R. A1 - Dominique Van Beckhoven KW - Belgique KW - de KW - SIDA KW - situation KW - VIH PB - WIV-ISP CY - Bruxelles SN - D/2011/2505/48 U1 - 33830 U2 - 2011/25 ER - TY - RPRT T1 - Epidemiologie van AIDS en HIV-infectie in België. Toestand op 31 december 2010 Y1 - 2011 A1 - André Sasse A1 - Verbrugge,R. A1 - Dominique Van Beckhoven KW - België PB - WIV-ISP CY - Brussel SN - D/2011/2505/49 U1 - 33831 U2 - 2011/26 ER - TY - RPRT T1 - Epidemiologie van AIDS en HIV-infectie in België. Toestand op 31 december 2010. Y1 - 2011 A1 - André Sasse A1 - Verbrugge, Ruth A1 - Dominique Van Beckhoven KW - 2010 KW - AIDS KW - België KW - épidémiologie KW - HIV KW - infecties PB - WIV-ISP CY - Brussel, België ER - TY - JOUR T1 - Surveillance of sexually transmitted infections among persons living with HIV. JF - Int J Public Health Y1 - 2011 A1 - Defraye, Ann A1 - Dominique Van Beckhoven A1 - André Sasse KW - ADOLESCENT KW - Adult KW - Belgium KW - HIV KW - HIV Infections KW - Homosexuality, Male KW - Humans KW - Male KW - middle aged KW - Population Surveillance KW - Risk-Taking KW - Sexually Transmitted Diseases, Bacterial KW - Young adult AB -

OBJECTIVES: Surveillance of sexually transmitted infections (STI) among HIV patients in AIDS Reference Centers aims at identifying risk groups and detecting specific STI emerging in this population.

METHODS: Seven of the nine AIDS Reference Centers in Belgium participate in this surveillance. The reported STI include Chlamydia, gonorrhea, syphilis, Lymphogranuloma venereum, hepatitis B virus and newly acquired hepatitis C in men who have sex with men (MSM).

RESULTS: In 2008, 252 HIV patients (250 men, 2 women) were reported with a new STI episode. Sexual orientation was known for 245 men: 241 were MSM, 4 were heterosexual men. In total, 279 new STI episodes were reported. More than half of the diagnoses were syphilis. In 78% of the syphilis cases, the motive of the consultation was not related to an STI complaint.

CONCLUSIONS: The results underline the importance of regular STI screening among HIV-positive persons, and show a particular sexual health problem among MSM. We estimate that the proportion of HIV-positive MSM acquiring an STI in 2008 was 8.8%.

VL - 56 CP - 2 U1 - https://www.ncbi.nlm.nih.gov/pubmed/21127939?dopt=Abstract M3 - 10.1007/s00038-010-0209-5 ER - TY - RPRT T1 - Épidémiologie du SIDA et de l'infection à VIH en Belgique. Situation au 31 décembre 2009. Y1 - 2010 A1 - André Sasse A1 - Verbrugge, Ruth A1 - Buziarsist, Jamila A1 - Dominique Van Beckhoven KW - 2009 KW - Belgique KW - épidémiologie KW - infections KW - SIDA KW - VIH PB - WIV-ISP CY - Bruxelles, Belgique ER - TY - RPRT T1 - Epidemiologie van AIDS en HIV-infectie in België. Toestand op 31 december 2009. Y1 - 2010 A1 - André Sasse A1 - Verbrugge, Ruth A1 - Buziarsist, Jamila A1 - Dominique Van Beckhoven KW - 2009 KW - AIDS KW - België KW - épidémiologie KW - HIV KW - infecties PB - WIV-ISP CY - Brussel, België ER - TY - RPRT T1 - Bulletin épidémiologique intermédiaire sur les infections sexuellement transmissibles Y1 - 0 A1 - Amaryl Lecompte A1 - Dominique Van Beckhoven A1 - Jessika Deblonde A1 - Van den Bossche Dorien (NRC STI, ITG) A1 - de Baetselier Irith (NRC STI, ITG) A1 - Dhaeze Wouter (departement Zorg) A1 - Ngandjui Ngandjui Raphaël (AViQ) A1 - Delpire Maïté (AViQ) A1 - Lamot Thomas (Vivalis) ER - TY - Generic T1 - Continuum of HIV care by key populations in Belgium: Cross-sectional and longitudinal views Y1 - 0 A1 - Dominique Van Beckhoven A1 - Ben Serrien A1 - Gilles Darcis A1 - Demeester, Rémy A1 - De Munter, Paul A1 - Sophie Henrard A1 - Agnès Libois A1 - Peter Messiaen A1 - Jens Van Praet A1 - Macq, Jean ER - TY - RPRT T1 - Mycosen. Epidemiologische surveillance in België. 2016-17. Y1 - 0 A1 - Dominique Van Beckhoven A1 - Rosalie Sacheli A1 - Sofie Patteet A1 - Marie-Pierre Hayette A1 - Lagrou, Katrien ER - TY - RPRT T1 - Mycoses. Surveillance épidémiologique en Belgique. 2016-17. Y1 - 0 A1 - Dominique Van Beckhoven A1 - Rosalie Sacheli A1 - Sofie Patteet A1 - Marie-Pierre Hayette A1 - Lagrou, Katrien ER - TY - RPRT T1 - Tussentijds epidemiologisch bulletin over seksueel overdraagbare infecties Y1 - 0 A1 - Amaryl Lecompte A1 - Jessika Deblonde A1 - Dominique Van Beckhoven A1 - Van den Bossche Dorien (NRC STI, ITG) A1 - de Baetselier Irith (NRC STI, ITG) A1 - Dhaeze Wouter (departement Zorg) A1 - Ngandjui Ngandjui Raphaël (AViQ) A1 - Delpire Maïté (AViQ) A1 - Lamot Thomas (Vivalis) ER -