HIV-INFECTION IN DIALYSIS CENTERS IN ITALY - A NATIONWIDE MULTICENTERSTUDY

The prevalence of HIV infection in dialysis populations varies accordi ng to different countries and geographic areas, We performed a nationw ide epidemiological study by means of a questionnaire in the period fr om January 1990 to December 1995, Questions were about whether and whi ch HIV tests were performed and which preventive measures were adopted . A separate survey evaluated the data the HIV-positive patients. Only 62% of the centers responded to the questionnaire, corresponding to 2 1,500 dialysis patients in 1990 and 27,000 in 1995, The prevalence of HIV-positive subjects was 0,13% for 1995, A total of 48 patients with HIV infection were identified: risk factors were drug abuse in 16 case s, homosexuality in 9, heterosexual contact in 8, transfusion in 7, re nal transplant in 3 and unknown cause in 5, Forty-five patients were o n hemodialysis, and 3 were receiving peritoneal dialysis. At follow-up , 19 patients died: infection and malnutrition were the most frequent causes of death, The death rate of patients who were already HIV posit ive when dialysis was started (group 1, 29 cases) was 19.36 deaths/1,0 00 patient/month, The correlations, performed only for group 1, showed a significantly worse prognosis for patients with CD4 < 200/mm(3) and for those with AIDS. In conclusion, in Italy the prevalence of HIV in fection in the dialysis population is low, and the outcome of HIV-posi tive patients in dialysis was found to be better than earlier literatu re reports. The use of chronic dialysis for HIV patients with uremia s hould not be discouraged.