More people in the UK are starting HIV treatment earlier in order to reduce the risk of transmission

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March 2015 PREP Gender
all this is very good! But only with condoms
all this is very good! But only with condoms
There is evidence of increasing interest in the treatment of HIV as prevention among people living with HIV in the UK; with the number of people who start treatment with high counts of CD4 that duplicate over a five-year period, according to data presented at an England Public Health meeting this week. In 2013, 49% of people who started treatment had CD4 counts greater than 350 cells / mm3, including 27% of them with more than 500 cells / mm3. Considering some international guidelines recommend treatment starting HIV with a CD4 cell count of 500 cells / mm3 or higher, the authors of the British guidelines do not believe that there is clear evidence that this will lead to better individual health outcomes. In general, UK guidelines recommend that treatment be started with a CD4 count of around 350 cells / mm3. However, treatment with a higher CD4 count is recommended if an individual has a co-morbidity, such as hepatitis B, hepatitis C, tuberculosis, HIV-related kidney diseases or HIV-related cognitive illness. Pregnant women must also start HIV treatment, regardless of their CD4 count because this reduces the chances of the unborn child being born HIV-positive by 97%. In addition, since 2012, the UK guidelines have also recommended that doctors should discuss the evidence for the effectiveness of antiretroviral treatment as prevention with all HIV patients. Regardless of the CD4 cell count, any individual who wishes to have treatment in order to protect their partners from the risk of HIV infection must be able to do so and have the right to do so. Absorption of early treatment In 2008, 75% of the 57.752 adults diagnosed with HIV were on therapy. In 2013, this had increased to 86% of the 77.702 people diagnosed with HIV.Sesso Sicuro Looking more specifically at those on initial therapy, the average CD4 cell count increased over the five-year period. Considering that 24% of people who had an initial therapy had a CD4 cell count over 350 cells / mm3 in 2008, that percentage increased to 49% in 2013. In addition, proportions with a CD4 cell count greater than 500 cells / mm3 rose from 8% to 27%. Some who started treatment from a higher CD4 cell count will have done so due to a co-morbidity or as part of a clinical trial, but the significant increase is likely to be due to increased awareness of the prevention benefits of HIV treatment. People aged 25-34 years, white people and men who have sex with men were more likely to have treatment at a higher CD4 cell count than members of other demographic groups. People who had been diagnosed within a few months of their own infection were four times more likely to start treatment earlier than people who had been diagnosed at a later stage. People receiving treatment at a larger HIV clinic (with more than 1000 patients) were more likely to do so than people seen at a smaller clinic. All of these differences were statistically significant after adjusting these factors. Looking at the results one year after starting treatment on a high CD4 cell count, 91% were still on treatment. However, 5% appeared to have given up care or to have left the country (a similar proportion to that of other groups of HIV-positive patients in the UK) and 2% still did not take care and did not undergo HIV treatment. A year later, 90% of them had a viral load undetectable. But while the results were generally good, some groups were at higher risk of low adherence and of not achieving undetectability, especially the younger ones. Overall, 23%
Burning woman has condoms in mind
Burning woman has condoms in mind
das pessoas com idade entre os 15-24 anos e 13% na faixa etária 25-34 anos não têm uma carga viral indetectável. Resultados um pouco piores foram observados também em homens heterossexuais, pessoas que vivem em áreas carentes e aqueles que iniciaram o tratamento com uma contagem de células CD4 acima de 500 células / mm3 (em vez de entre 350 e 500 células / mm3). Essas diferenças foram estatísticamente significantes após o ajuste destes fatores. Os resultados mostram que, embora as diretrizes de tratamento do Reino Unido não considerem recomendável que todas as pessoas com uma contagem de células CD4 superiores devam iniciar o tratamento do HIV, muitas pessoas estão optando por fazê-lo. Além disso, os epidemiologistas apontam que a captação de tratamento já é muito elevada e que a mudança de diretrizes para uma recomendação mais firme para o tratamento precoce teria apenas um impacto limitado sobre o número total de pessoas que recebem terapia anti-retroviral. Em 2012, 60.850 pessoas receberam tratamento. Se todos os pacientes com uma contagem de células CD4 abaixo de 500 células / mm3 aceitarem iniciar sues tratamentos, mais 6.100 pessoas seriam tratadas. O fornecimento de tratamento para cada pessoa diagnosticada no país acrescentaria mais 6.550 pessoas, elevando o total para 73.430. Isto sugere que nem o impacto financeiro – nem o benefício para a saúde pública – das diretrizes de tratamento recomendando fortemente o tratamento precoce seriam esmagadores. O impacto na saúde pública do tratamento como prevenção é mais provável de ser realizado se mais pessoas tenham o diagnóstico precoce da infecção. the creator of the siteNote from the editor of Soropositivo Web Site: Although I am personally refractory to the use of treatment as a prevention (I mean by saying that although my viral load has been undetectable for years and that I have been following the same line of treatment for years, I, if I were to have an extramarital affair [port literally dead to me] I would never stop using the condom, even if the partner asked for it on her knees because I know what I saw, almost twenty years ago and the idea of ​​putting someone at risk, even if hypothetical to go through it, I wouldn't); and even so, I must say that the article, based on a British study, must be taken into consideration by patients, doctors, researchers from Brazil and the world! With that, I want to clarify that, although I do not agree with that from me to myself, I think that other people should evaluate their lives in this light and, who knows, we may not be able to reach the end of the AIDS, if not for 2030, at least for 2040. I very much doubt that I am here to see all this, although I fight passionately for life. But I have been living with HIV for so long that it is hard for me to believe that I will be able to live another 25 years like this. But I would do it, and happy, if the one I call is beside me, shamelessly copying Getúlio Vargas, A Bem Amada. Reference Brown A et al. Evidence for HIV treatment in England, Wales and Northern Ireland.HIV/AIDS Reporters’ Meeting, Public Health England, March 23 2015. Roger Pebody Publicado em: 25 de março, 2015 Traduzido para o Português do Brasil por Cláudio Santos de Souza em 27 de março de 2015 do Original m inglês: More people in the UK are starting HIV treatment early, in order to reduce their risk of transmission Revised by Beloved

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