瑞士的艾滋病病毒治疗连续过程：实现联合国艾滋病规划署/世界卫生组织针对艾滋病病毒确诊患者设定的目标。
The HIV care cascade in Switzerland: reaching the UNAIDS/WHO targets for patients diagnosed with HIV.
作者信息
Kohler Philipp, Schmidt Axel J, Cavassini Matthias, Furrer Hansjakob, Calmy Alexandra, Battegay Manuel, Bernasconi Enos, Ledergerber Bruno, Vernazza Pietro
机构信息
aDivision of Infectious Diseases and Infection Control, Cantonal Hospital St. Gallen bDivision of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich cCommunicable Diseases Division, Federal Office of Public Health (FOPH), Bern, Switzerland dDepartment of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, UK eDivision of Infectious Diseases and Hospital Epidemiology, University Hospital Lausanne fUniversity Clinic of Infectious Diseases, University Hospital Bern gHIV Unit, Geneva University Hospital, Geneva hDivision of Infectious Diseases and Hospital Epidemiology, University Hospital Basel iOspedale Regionale, Lugano, Switzerland.
出版信息
AIDS. 2015 Nov 28;29(18):2509-15. doi: 10.1097/QAD.0000000000000878.
OBJECTIVES
To describe the HIV care cascade for Switzerland in the year 2012.
DESIGN/METHODS: Six levels were defined: (i) HIV-infected, (ii) HIV-diagnosed, (iii) linked to care, (iv) retained in care, (v) on antiretroviral treatment (ART), and (vi) with suppressed viral load. We used data from the Swiss HIV Cohort Study (SHCS) complemented by a nationwide survey among SHCS physicians to estimate the number of HIV-patients not registered in the cohort. We also used Swiss ART sales data to estimate the number of patients treated outside the SHCS network. Based on the number of patients retained in care, we inferred the estimates for levels (i) to (iii) from previously published data.
RESULTS
We estimate that (i) 15 200 HIV-infected individuals lived in Switzerland in 2012 (margins of uncertainty, 13 400-19 300). Of those, (ii) 12 300 (81%) were diagnosed, (iii) 12 200 (80%) linked, and (iv) 11 900 (79%) retained in care. Broadly based on SHCS network data, (v) 10 800 (71%) patients were receiving ART, and (vi) 10 400 (68%) had suppressed (<200 copies/ml) viral loads. The vast majority (95%) of patients retained in care were followed within the SHCS network, with 76% registered in the cohort.
CONCLUSION
Our estimate for HIV-infected individuals in Switzerland is substantially lower than previously reported, halving previous national HIV prevalence estimates to 0.2%. In Switzerland in 2012, 91% of patients in care were receiving ART, and 96% of patients on ART had suppressed viral load, meeting recent UNAIDS/WHO targets.
目的
描述2012年瑞士的艾滋病毒治疗流程。
设计/方法：定义了六个阶段：（i）艾滋病毒感染；（ii）艾滋病毒诊断；（iii）与治疗机构建立联系；（iv）持续接受治疗；（v）接受抗逆转录病毒治疗（ART）；（vi）病毒载量得到抑制。我们使用了瑞士艾滋病毒队列研究（SHCS）的数据，并辅以对SHCS医生进行的全国性调查，以估算未纳入该队列研究的艾滋病毒患者数量。我们还使用了瑞士抗逆转录病毒治疗药物销售数据，以估算在SHCS网络之外接受治疗的患者数量。根据持续接受治疗的患者数量，我们从先前发表的数据中推断出阶段（i）至（iii）的估算值。
结果
我们估计，（i）2012年瑞士有15200名艾滋病毒感染者（不确定范围为13400 - 19300）。其中，（ii）12300人（81%）被诊断出感染，（iii）12200人（80%）与治疗机构建立联系，（iv）11900人（79%）持续接受治疗。大致基于SHCS网络数据，（v）10800人（71%）正在接受抗逆转录病毒治疗，（vi）10400人（68%）的病毒载量得到抑制（<200拷贝/毫升）。持续接受治疗的患者中，绝大多数（95%）在SHCS网络内接受随访，其中76%登记在该队列研究中。
结论
我们对瑞士艾滋病毒感染者的估计数大幅低于先前报告的数据，将之前全国艾滋病毒流行率的估计值减半至0.2%。2012年在瑞士，91%接受治疗的患者正在接受抗逆转录病毒治疗，96%接受抗逆转录病毒治疗的患者病毒载量得到抑制，达到了联合国艾滋病规划署/世界卫生组织近期的目标。
Zotero 插件