Abstract
ABSTRACTObjective:To characterize the sociodemographic profile of the population undergoing antiretroviral treatment in the state of Paraná, Brazil, to investigate the proportion of people undergoing treatment among all those diagnosed, and to analyze the proportion of patients with suppressed viral load in different regions of the state.Methods:Observational descriptive and analytical study carried out with information referring to the period from January 2018 to January 2019. Data were obtained from the Sistema Informatizado de Monitoramento Clínico das Pessoas Vivendo com HIV/AIDS [Computerized System for Clinical Monitoring of People Living with HIV/AIDS] and Sistema de Controle Logístico de Medicamentos[Drug Supply Control System]. The proportion of people on antiretroviral treatment in the state and the proportion of patients with viral load ≤1,000 copies/mL and ≤50 copies/mL were calculated. The results were compared with the corresponding parameters of the World Health Organization goal 90-90-90.Results:The state of Paraná managed to reach the second and third parameters of the 90-90-90 goal of the World Health Organization. Among those diagnosed, 93.12% were on antiretroviral treatment, and 90.0% of them had a viral load below 50 copies of viral RNA/mL of blood, indicating virologic success.Conclusion:The health policy aimed at the population living with HIV/AIDS, and the health services available in Paraná have been successful in parameters relevant to the control of the epidemic. However, it is necessary to ensure the diagnosis of people infected with HIV in the population.
Highlights
There is the Sistema de Monitoramento Clínico das Pessoas Vivendo com human immunodeficiency virus (HIV)/AIDS (SIMC) [System for Clinical Monitoring of People Living with HIV/AIDS], which monitors the number of people diagnosed with HIV/ AIDS, and those who already have a diagnosis have not yet initiated antiretroviral therapy, in addition to providing access to laboratory test results.[5]
The study analyses considered the cutoff of 1,000 copies/ mL based on the global United Nations Programme on HIV/AIDS (UNAIDS)/World Health Organization (WHO) target,(3) and 50 copies/mL based on the Clinical Protocol and Therapeutic Guidelines.[5]
In January 2019, the end of the study period, 34,472 people had been diagnosed with HIV in the state of Paraná, 93.12% of which were on antiretroviral therapy
Summary
Viral load suppression is a key marker for effectiveness of antiretroviral therapy, risk of progression of clinical disease and the chance of transmitting the human immunodeficiency virus (HIV).(1,2) Based on this marker, it is possible to guide health planning and efforts to control infection.[1]With this purpose, health systems in different countries follow up the diagnosis and treatment of people living with HIV/AIDS, through actions resulting in a cascade of care, including HIV screening, linkage to care, onset of therapy with antiretrovirals, monitoring patient compliance to drug therapy and, at last, viral suppression.[1]In 2014, the Joint United Nations Programme on HIV/AIDS (UNAIDS) of the World Health Organization (WHO) proposed a target known as 9090-90, aiming to diagnose 90% of people living with HIV/AIDS, treat 90% of them with antiretroviral drugs, and achieve viral load suppression in 90% of people on treatment. Viral load suppression is a key marker for effectiveness of antiretroviral therapy, risk of progression of clinical disease and the chance of transmitting the human immunodeficiency virus (HIV).(1,2) Based on this marker, it is possible to guide health planning and efforts to control infection.[1]. With this purpose, health systems in different countries follow up the diagnosis and treatment of people living with HIV/AIDS, through actions resulting in a cascade of care, including HIV screening, linkage to care, onset of therapy with antiretrovirals, monitoring patient compliance to drug therapy and, at last, viral suppression.[1]. There is the Sistema de Monitoramento Clínico das Pessoas Vivendo com HIV/AIDS (SIMC) [System for Clinical Monitoring of People Living with HIV/AIDS], which monitors the number of people diagnosed with HIV/ AIDS, and those who already have a diagnosis have not yet initiated antiretroviral therapy (treatment gap), in addition to providing access to laboratory test results.[5]
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