The HIV epidemic in Greenland – a slow spreading infection among adult heterosexual Greenlanders

Figures & data

Table I. Characteristics of the HIV population in Greenland, N (%)

	Total
Total^a	171
Died in Greenland	79 (46.2)
Living with HIV in Greenland	67 (39.2)
Emigrated	25 (14.6)
Gender
Males	112 (65.5)
Females	59 (34.5)
Race
Greenlandic	145 (84.8)
Caucasian	15 (8.8)
Unknown	8 (4.7)
Asian	2 (1.2)
Negroid	1 (0.6)
Mode of transmission
Heterosexual	127 (74.3)
Homosexual/bisexual	30 (17.5)
Unknown	9 (5.3)
Injection drug abuse	3 (1.8)
Blood transfusion	2 (1.2)
Perinatal	+2
Place of transmission
Greenland	133 (77.8)
Denmark	17 (9.9)
Unknown	8 (4.7)
Asia, Africa, Europe, Middle East	13 (7.6)
Town of residency
– Town of transmission
Nuuk	89 (52.0)
– Local transmission	71
Sisimiut	43 (25.1)
– Local transmission	40
Tasiilaq	8 (4.7)
– Local transmission	5
Rest of Greenland	31 (18.1)
– local transmission	17
Median age (years)	46 (IQR 34–56)
Advanced HIV^b	31 (18.1)
Late presenters^c	68 (39.8)

^aTwo children perinatally infected not included in the analysis.

^bIf AIDS at diagnosis and/or CD4 count <200 measured less than 6 months after diagnosis.

^cIf AIDS at diagnosis and/or CD4 count >350 measured less than 6 months after diagnosis.

Fig. 1.  Area of reported HIV cases, incidence and prevalence/100,000 inhabitants >15 years of age. Number of persons reported with HIV in Nuuk, Sisimiut and the rest of Greenland.

Table II. Number of deaths, mortality rates (MR) and causes of death for all HIV patients dying in Greenland in the study periods stratified by year of HIV diagnosis

	Complete period	Pre-HAART	Early-HAART	Late-HAART
Total number of deaths^a (n)	79	16	39	24
Total observational time (years)	1143.3	245.0	448.5	449.4
MR/1,000 PY (95% CI)	69.1 (55.4–86.2)	65.3 (40.0–106.6)	87.0 (63.5–119.0)	53.4 (35.8–79.7)
Median last CD4 count before death^b (IQR)	190 (65–366)	137 (40–447)	190 (60–420)	250 (97–505)
On HAART before death [n (%)]	47 (62.0)	0	26 (66.7)	21 (87.5)
Median age at time of death [years (IQR)]	57.4 (47.4–65.0)	53.4 (41.2–60.8)	52.0 (46.2–61.4)	65.0 (59.1–70.2)
AIDS-related deaths [n (%)]	43 (54.4)	9 (56.3)	24 (61.5)	10 (41.7)
MR/1,000 PYR (95% CI)	37.6 (27.9–50.7)	36.7 (19.1–70.6)	53.5.1 (35.9–79.8)	22.3 (12.0–41.4)
– Aids-defining illness <1 year before death	28
– CD4cells <200 at time of death	19
– Opportunistic infections^c	12
– HIV wasting	9
– Kaposi sarcoma	3
– Lymphoma	2
Non-AIDS-related deaths [n (%)]	32 (40.5)	6 (37.5)	13 (33.3)	13 (54.2)
MR/1,000 PYR (95% CI)	28.0 (19.8–39.6)	24.5 (11.0–54.5)	29.0 (16.8–49.8)	28.9 (16.8–49.8)
– Cancer^d	8
– Infections^e	8
– Other^f	8
– Unknown	4
– Cardiovascular^g	4
Unnatural deaths [n (%)]	4 (5.1)	1 (6.3)	2 (5.1)	1 (4.2)
MR/1,000 PYR (95% CI)	3.5 (1.3–9.3)	4.08 (0.57–28.98)	4.5 (1.1–17.83)	(0.3–15.8)
– Suicide	2
– Aspiration/drowning	2

Pre-HAART (≤1996), early-HAART (1997–2004), late-HAART (≥2005).

^aPatients known to have died after moving to Denmark are excluded from this analysis.

^bOnly included, if measured <6 months before death.

^c Pneumocystis carini infections: 5, tuberculosis: 1, unknown: 6.

^dLung cancer: 4, oesophageal cancers: 2, cancer in the oral cavity: 1, cerebral cancer: 1, stomach cancer: 1.

^ePneumonia: 4, urinary tract infection: 1, gastroenteritis: 1, sepsis: 1, unknown infection: 1.

^fAlcohol related: 2, bowel perforation: 2, chronic obstructive lung disease: 1, cerebral haemorrhage: 1, other bleeding: 1, age: 1.

^gAcute myocardial infarction: 3, cardiac arrest: 1.

Fig. 2.  Kaplan–Meier curve showing survival of HIV patients living in Nuuk versus HIV patients living in the rest of Greenland in the total study period.