Cascade of care for people living with HIV infection in Southern Brazil: results from a public health network

Abstract

A cascata de cuidados para pessoas vivendo com a infecção pelo HIV no Sul do Brasil: resultados obtidos em uma rede pública de saúde Serie de cuidados para personas que viven con una infección de VIH en el sur de Brasil: resultados en una red pública de salud AbstractThe cascade of care for people living with HIV infection (PLHIV) describes steps in diagnosis, linkage and retention in care, as well as the provision and success of combination antiretroviral therapy (cART). The aim of this study was to evaluate the rates regarding the retention in care, on cART, and suppressed viral load for PLHIV attended at a Brazilian public health network. Data on PLHIV from 116 cities of Paraná, Southern Brazil, attended from 2012 to 2015, were retrospectively collected through the Laboratory Tests Control System (SISCEL). The number of PLHIV related to care increased about 22.5% from 2012 to 2015 (4,106 to 5,030 individuals). The proportion of PLHIV retained in care showed a trend toward stabilization around 81.7-86.9%. Every year, the use of cART increased up to 90.3% for PLHIV retained in care. Viral load suppression was achieved by 72.8% of patients on cART and 57.1% by those linked to care. Retention in care and HIV viral suppression were more likely to occur in older PLHIV than younger ones; similarly, patients living in medium-sized cities were more susceptible to these factors than in large-or small-sized cities. In conclusion, the study showed a high level of retention in care and HIV suppression on cART, as well as emphasized that current efforts for treating already-infected PLHIV remain a challenge for our health public institutions and may contribute to highlight steps for improvement of the HIV cascade of care in our population. HIV; Highly Active Antiretroviral Therapy; Sustained Virologic ResponseCorrespondence E. M. V. Reiche

HIV/AIDS epidemic in a western border municipality of Rio Grande do Sul, Brazil: evolution, HIV cascade of care and lethality

“…Despite observing the achievement of the target in 2015, a more prolonged analysis is still necessary to verify the continuity of this result. A study developed with patients seen at a university hospital in Paraná, between 2012 and 2015, demonstrated that there is still considerable distance to reach the goals 90-90-90 38 , similarly to the results of this study.…”

Epidemiological analysis of human immunodeficiency virus [HIV] disease between 2010 and 2019

“…HIV is a serious public health issue (11) , because even after decades of studies there is no effective cure or vaccine that protects the population against this virus (13,(17)(18)(19)(20)(21)(22)(23)(24) . Thus, even if many efforts have been made worldwide to control and treat the disease, giving greater life expectancy to its carriers, the levels of hospitalization and death due to the infection remain high (12,14,15,20,22) , as well as the increase of the infection, which is still seen in some populations not traditionally associated with the illness, as women and heterosexuals (13,16) .…”

“…The existing inequalities in the insertion of the response to HIV and in the presence of situations that can favor directions for the occurrence of AIDS are shown to be quite complex, configuring aggregation of regional sub-epidemics (15,19) . Despite the achievements made in mortality reduction, awareness campaigns should not be reduced, as well as the distribution of condoms, the encouragement of rapid tests and the expansion of knowledge regarding to this disease among the population (23,24) These campaigns are important, because even though there have been drops in hospitalizations and mortality due to the HIV virus over the years, there are, in some countries and Brazilian states, much higher rates than expected, as corroborated by our research on Datasus.…”

Virologic success under antiretroviral therapy among people living with HIV/AIDS in the state of Paraná, Brazil

“…similarly to the numbers achieved by the state of Paraná, in 2015. (16) Based on information obtained from the Sistema de Controle de Exames Laboratoriais (SISCEL) [Laboratory Test Control System] and SICLOM systems, the proportion people diagnosed with HIV and on antiretroviral therapy was 93.12% of all those diagnosed in the state of Paraná. This means that, during the study period, the state had already achieved the second UNAIDS target of providing therapy to 90% of HIV-diagnosed population.…”