Paediatric AIDS incidence in Europe and the USA, 1985-96.

BACKGROUND: AIDS has shown dramatic increases among women in the last decade; this has facilitated the spread of paediatric AIDS. Incidence rates of AIDS in children are essential for international comparisons at a population level. METHODS: Incidence rates of AIDS 1985-96 by 3-year period in children <13 years of age were computed for 15 European countries and, for comparative purposes, the USA. For each country, the rates were adjusted for reporting delay and standardised on the world standard population. RESULTS: In European countries with > 100 cases, the steepest rises were seen in the UK (whose rates increased from 0.8/1,000,000 children in 1985-87 to 4.1/1,000,000 in 1994-96), and Spain (from 4.4/1,000,000 to 16.5/1,000,000). In 1985-87, rates were substantially higher in USA (8.3/1,000,000) than in any European country but, in recent years, they have become similar to those of Spain. Very elevated rates were observed in Romania, with incidences of 120.4/1,000,000 in the early 1990s, due to nosocomial HIV transmission. In most countries, 1994-96 rates tended to level off, or decrease. In a few countries (Germany, Greece, Denmark, Austria, and the Netherlands) AIDS incidence rates were <2 cases per million children in 1994-96. The proportion of cases acquired by transfusion, in 1985-96, is about 20% or less of paediatric AIDS cases in most countries. No substantial heterogeneity emerges between countries in the distribution of AIDS indicator diseases. CONCLUSIONS: During 1985-93, paediatric AIDS incidence rates increased in most European countries and levelled off thereafter. No paediatric AIDS epidemic occurred; in a few countries, incidence rates persisted at around one case per million.