Demographic and clinical characteristics of HIV-infected patients in Ekaterinburg

Abstract

Aim. To study the demographic and clinical characteristics of patients with HIV infection during registration in the period from 2016 to 2020 in the city of Ekaterinburg.Materials and methods. The study was conducted on the basis of the Sverdlovsk Regional Center for the Prevention and Control of AIDS, Ekaterinburg. The data of 4222 patients with HIV infection registered in the period from 2016 to 2020 were analyzed retrospectively.Results and discussion. This study included a large number of patients with HIV infection registered for 5 years, which made it possible to comprehensively assess the portrait of a patient with HIV infection at the present stage, reflecting the demographic and clinical parameters of the cohort. A downward trend in the detection of HIV infection from 2016 to 2020 was noted; reducing the time from the detection of HIV infection to the start of dispensary observation and the appointment of antiretroviral therapy (ART); increase in the proportion of patients of older age groups. The maximum terms of registration were noted in the group of injecting drug users. The proportion of patients with comorbidities is 75–86%, which requires expanding the possibilities for choosing an ART regimen. Most of naïve patients receive «non-nucleoside reverse transcriptase inhibitor (NNRTI) and two nucleoside reverse transcriptase inhibitors (NIOT)» and «protease inhibitor (PI) and two NIOT», as a first line treatment, integrase inhibitors account for 6.9%.Conclusion. Despite the positive dynamics of indicators regarding the start of medical examination and treatment of patients with HIV infection in the period from 2016 to 2020, in order to reduce the time for involving patients, additional research and subsequent interventions are required in the identified gender, age and clinical risk groups, as well as ensuring accessibility modern ART and an increase in the proportion of fixed combinations of ARV drugs in it. The increase in the average age of patients, high polypharmacy and the need to reduce the risk of possible drug interactions argue in favor of the need to increase the proportion of integrase inhibitors.In order to determine the patient’s responsibility for monitoring and treating their disease, the Federal Law of March 30, 1995 No. 38-FL «On the Prevention of the Spread in the Russian Federation of a Disease Caused by the Human Immunodeficiency Virus (HIV)» needs to be brought into line with the Federal Law dated November 21, 2011 No. 323-FL «On the fundamentals of the health of citizens in the Russian Federation».