Chkhartishvili N, Sharavdze L, Chokoshvili O, DeHovitz J A, del Rio C, Tsertsvadze T
Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia.
HIV Med. 2015 Jan;16(1):62-6. doi: 10.1111/hiv.12172. Epub 2014 Jun 12.
Individual and public health benefits of antiretroviral therapy (ART) rely on successful engagement of HIV-infected patients in care. We aimed to evaluate the HIV care continuum in the Eastern European country of Georgia.
The analysis included all adult (age ≥ 18 years) HIV-infected patients diagnosed in Georgia from January 1989 until June 2012. Data were extracted from the national HIV/AIDS database as of 1 October 2012. The following stages of the HIV care continuum were quantified: HIV infected, HIV diagnosed, linked to care, retained in care, eligible for ART and virologically suppressed.
Of 3295 cumulative cases of adult HIV infection reported in Georgia, 2545 HIV-infected patients were known to be alive as of 1 October 2012, which is 52% of the estimated 4900 persons living with HIV in the country. Of the 2545 persons diagnosed with HIV infection, 2135 (84%) were linked to care and 1847 (73%) were retained in care. Of 1446 patients eligible for ART, 1273 (88%) were on treatment and 985 (77%) of them had a viral load <400 HIV-1 RNA copies/mL. Overall, 39% of those diagnosed and 20% of those infected had a suppressed viral load.
The findings of our analysis demonstrate that the majority of patients diagnosed with HIV infection are retained in care. Loss of patients occurs at each step of the HIV care continuum, but the major gap is at the stage of HIV diagnosis. Reducing the number of persons living with undiagnosed HIV infection and simultaneously enhancing engagement in continuous care will be critical to achieve maximum individual and public health benefits of ART.
抗逆转录病毒疗法（ART）对个人和公共健康的益处依赖于艾滋病毒感染患者成功接受治疗。我们旨在评估东欧国家格鲁吉亚的艾滋病毒治疗连续过程。
分析纳入了1989年1月至2012年6月在格鲁吉亚诊断出的所有成年（年龄≥18岁）艾滋病毒感染患者。数据截至2012年10月1日从国家艾滋病毒/艾滋病数据库中提取。对艾滋病毒治疗连续过程的以下阶段进行了量化：艾滋病毒感染、艾滋病毒诊断、与治疗机构建立联系、持续接受治疗、符合抗逆转录病毒疗法治疗条件以及病毒得到抑制。
格鲁吉亚报告的3295例成年艾滋病毒感染累积病例中，截至2012年10月1日已知有2545例艾滋病毒感染患者存活，占该国估计4900名艾滋病毒感染者的52%。在2545例诊断出艾滋病毒感染的患者中，2135例（84%）与治疗机构建立了联系，1847例（73%）持续接受治疗。在1446例符合抗逆转录病毒疗法治疗条件的患者中，1273例（88%）正在接受治疗，其中985例（77%）的病毒载量<400拷贝/mL艾滋病毒-1RNA。总体而言，诊断出的患者中有39%以及感染者中有20%的病毒载量得到了抑制。
我们的分析结果表明，大多数诊断出艾滋病毒感染的患者持续接受治疗。艾滋病毒治疗连续过程的每个阶段都会有患者流失，但主要差距在于艾滋病毒诊断阶段。减少未被诊断出的艾滋病毒感染者数量，同时加强持续治疗的参与度，对于实现抗逆转录病毒疗法对个人和公共健康的最大益处至关重要。
