HIV positive patients with antiretroviral therapy and viral suppression
The proportion of HIV-positive patients treated in the United States who accessed antiretroviral therapy (HAART) and achieved viral suppression increased substantially between 2009 and 2013, according to research published in the online edition of the journal "AIDS ".
There was an overall increase of 6% in the proportion of patients with prescription of antiretroviral drugs, whereas the proportion of patients with viral suppression and sustained viral suppression increased 11 17% and% respectively. The increases were more pronounced in young people aged between 18-29 and black.
"This analysis demonstrates a consistent increase in the prescription of ART (Antiretroviral Therapy) and viral suppression among people under medical care for HIV infection in the United States, globally and in nearly all subgroups and demographic characteristics analyzed", commenting, with The researchers. "However, there is still a significant difference between the percentage of patients receiving antiretroviral therapy and who achieve viral suppression."
In 2012, the United States Department of Health and Human Services issued updated guidelines recommending that all people with HIV should receive antiretroviral therapy. One of the main objectives of the US National Strategy against HIV / AIDS is an initiative to increase access to health care and improve outcomes for people with HIV. undetectable viral load is a key marker for HIV results is associated with a low risk of disease progression and transmission to sexual partners (to learn more, read about the Study Partner). Editor's Note: This is Law in Brazil, promulgated by the President "away" (SIC) Dilma Rousseff.
A team of researchers from the Disease Control and Prevention Centers analyzed data collected between 2009 and 2013 to estimate trends in prescription of ARV therapy and viral suppression among patients in HIV care.
Data were obtained from the Medical Monitoring Project, a nationally representative sample of HIV-positive patients in adult patients receiving medical care.
The authors calculated the percentage of patients with prescription for antiretroviral therapy (new and ongoing prescriptions), with viral suppression (viral load below 200 copies / ml at the last monitoring) and sustained with viral suppression (viral load below 200 copies / ml in all the tests in a period of twelve months). -In Brazil viral suppression is understood by a count of less than forty HIC copies per milliliter of blood. I do not understand well the health policy of the US, but in a country where the people vote for a president and, depending on the opinion of "delegates and SUPER-DELEGATES, who will live in the Oval Office is what lost the election by vote popular…
The results were encouraging for all three endpoints.
In 2013, 94% of patients in HIV care were receiving antiretroviral therapy and compared with 88,7% in 2009. This increased 6% was significant (p <0,01). Increases were observed in almost all subgroups. A larger increase was observed for women compared to men (10% versus 5%, respectively). Use of antiretroviral therapy has increased 24% among patients aged 18 and 29 years of 72% in 2009 to 89% in 2013. ART prescription increased 8% among blacks, 7% among Hispanics and 3% among whites. However, in 2013, white (WASP?) Also showed a significant higher possibility of being receiving ART in relativity to black (95% versus 93%, p = 0,01).
Among 2009 and 2013, the proportion of patients with viral suppression increased 72% to 80%, an increase of 11% (trend p <0,01). Increases were observed in each subgroup. The magnitude of the increase was greater among women compared to men (16% versus 10%, respectively), but there was a disparity results according to sex. In 2013, 81% of men and 77% of women had viral suppression (p <0,01). The proportion of younger patients with viral suppression increased from one-fifth. There was an increase of 18% for black, two times higher than that observed in white (8%) and Hispanic (9%). However, a gap still persisted according to "race" (the quotation marks are the translator), with 86% of white obtaining viral suppression in 2013 comparing the 75% of black skinned people.
The researchers calculated that the increased use of HAART represented 30% of the increase in the proportion of patients with viral suppression.
In 2009, 58% of patients had sustained viral suppression. This had increased to 68% by 2013, 17% increased over time (trend, p <0,01). Patients had an average of 2,8 viral load testing every year.
Sustained viral suppression increased by subgroups. 21% increase was observed in women compared to an increase of 16% in men. However in 2013 a higher proportion of men than women had suffered viral suppression (70% versus 64%, p <0,01). A large increase (60%) was observed in the proportion of patients under the age of 29 with sustained viral suppression. Despite this, only 51% of this age group had sustained viral suppression in 2013, compared to 74% of patients aged 50 and more. The proportion of black color of patients with sustained virologic suppression has increased almost one fourth, compared to an increase of 17% in Hispanic and increased 14% in white. However, in 2013 whites they were still significantly more likely to achieve viral suppression compared to blacks (76% versus 61%, p <0,01).
The authors estimated that 19% of the increase in the proportion of patients with sustained viral suppression could be attributed to increased use of ART.
"These findings illustrate progress towards NTMS goals of improving outcomes in health for people living with HIV sector, the researchers write.
They believe that several factors have contributed to this progress.
- Earlier start of ART.
- Improvements in HIV therapy that facilitated a better grip, such as reduced costs, reduced frequency of dosing and safer, less toxic therapies.
- Elimination of the drug assistance program against AIDS (adaptation) waiting lists
- Better case management and commitment to care
"Over a period of five years, viral suppression has increased significantly among people receiving clinical HIV care, the researchers conclude. However, they were concerned about the large and continuous gap between the proportion of patients with ART prescription and the percentage with sustained viral suppression. "Helping patients to sustain viral suppression may require greater efforts from clinical care providers and support service organizations to address the social and behavioral causes of factors affecting access to long-term medication compliance and general health care."
Published in: June 10 2016 to Aidsmap
Translated by Claudio Souza in 12 June 2016 in the original Big Increases in proportion of HIV-positive Patients in US treated with ART and viral suppression with
Editor's note: "Anyone can read the text and say, this is in America! So what ?! "Well, I would say that many of us have better results with a virions count below 40 copies per milliliter and therefore we are very well!
No, it is not. There is much to be done here, and the world, to come to "an AIDS-free world" (this world does not encompass, as far as I can see, China, Rússina, Mongolia and "part" of the Middle East). We return to knock on our media key is participatory than them interested and I see as a nightmare dantesto that "_canais_de_Televisão_ concessions are given to politicians, with due reverence I ask the few truly honest, that just will to implement its (s) box (es) not as a tick, parasite without giving anything in return to society that fuels with higher costs that would be required to support "a donkey bread sponge cake."
What we have is a result of the militancy of the 80 and 90 years, and of some of us who still live (God knows how) and still keep the flame burning. Beware of who you put in certain chairs because, in the dance of the chairs, it is not the dumbest that stands ... It is the weakest ... (...)
H Bradley et al.Increased ART prescription and HIV viral suppression Among persons receiving clinical care for HIV infection. AIDS, online edition. DOI: 10.1097 / QAD.0000000000001164 (2016).