Global HIV treatment programs need to be extended and implemented to meet and support UNAIDS 2030 goals
One of the most serious and unfortunately most neglected consequences of the Covid-19 pandemic is that too many patients with chronic or potentially chronic diseases (tumors, diabetes, cardiovascular disorders, infectious diseases such as HIV infection) have been neglected by epidemiological and follow-up studies. -up that kept them under constant control. In particular, in the case of HIV infection, many think that AIDS is a bit like diabetes: once the “right” therapy is found for each patient, chronicization is achieved and an average life span can be expected. not unlike that of the corresponding healthy population. However, the results of a recent study published by The Lancet HIV of December 2021 seem to disprove this illusion.
Among people with HIV who are on antiretroviral (ART) treatment worldwide, adults are close to 95% viral suppression, but among children and adolescents progress is lagging behind, so global viral suppression for a long time term remains a challenge. The study – multicentre – was promoted by the International Epidemiological Database for AIDS Assessment (IeDEA) funded by the US National Institutes of Health (IeDEA) in 2020 to estimate how close the world is to achieving the goal. The survey suggests that substantial efforts are still needed to help people with HIV suppress the virus in a lasting way.
People with HIV who have achieved viral suppression protect their immune health and help prevent transmission of HIV to others. In 2014, the United Nations Joint Program on HIV / AIDS (UNAIDS) set the goal of 95% viral suppression for all HIV-positive people treated with ART by 2030. The researchers analyzed data from 148 IeDEA treatment sites in 31 countries across five continents to estimate the proportions of children, adolescents and adults who had achieved viral suppression one, two and three years after the initiation of ART. The data comes from more than 21,500 children and adolescents with HIV aged 17 years and younger and more than 255,000 adults with HIV, all of whom had started receiving ART between 2010 and 2019. Viral suppression was defined as the presence less than a thousand copies of HIV per milliliter of blood. Researchers calculated the percentages of children and adults who achieved viral suppression based on data from those who were still alive at follow-up and for whom viral load measurements for up to three years of ART were available. To further estimate viral suppression among people who had dropped out of HIV treatment over the three-year study, the researchers looked at research conducted in Zambia on viral suppression rates in a similar population, then calculated an adjustment to the viral suppression rates in the IeDEA population. Following this procedure, the researchers estimated that among adults, 79% achieved viral suppression after one year of ART, 72% after two years, and 65% after three years. Among children and adolescents, 64% achieved viral suppression after one year of ART, 62% after two years, and only 59% after three years.
These viral suppression rates illustrate how far global HIV treatment programs must go to meet and support the UNAIDS 2030 goals, according to investigators. Importantly, the still low rates of viral suppression among children and adolescents with HIV underscore the need for improved approaches to achieving persistent viral suppression in these age groups.
December 4, 2021 (change December 4, 2021 | 15:59)