Introduction Controlling the epidemic by increasing access to care and suppressing viremia with adequate treatment is a central instrument in the UNAIDS and Brazilian strategy plan. Monitoring the implementation of test and treatment program is important to adjust the strategy to the different real world scenarios.
Methods We evaluated the outcome of 239 patients newly diagnosed HIV infections consecutively recruited from January 2011 to February 2015. Response to antiretroviral therapy (ART), CD4 (BD, USA) and viral load (Abbott, USA) were evaluated prospectively. Continuous variables as median and 25th-75th percentiles (IQR).
Results Most patients were (194/239 81.2%) male, 134/194 (69%) men who have sex with men, 109/204 (46%) white, age 32 (25-41), with disease staging (CDC2014) Zero (6.3%), 1 (33.1%), 2 (31.4%) e 3 (29.3%), with CD4 388 cells/mm³ (205-616) and viral load log104.55 (3.99–5.12). Follow-up information was available to 200/239 (83.7%), with 39 lost to follow-up due to: transferred without information 10 (4.18%), abandoned 20 (8.4%) and death 9 (3.8%). Treatment was prescribed to 212/239 (88.7%), with 6 deaths before initiating ART, 21 refusing treatment or loss to follow-up. Among 212 treated, at week 24, 171/212 (80.7%) had viral load log10 <3 (<1000 copies/mL, WHO suppression target) and 79%<200 c\mL (DHHS suppression target). If only cases with information were considered (n=190), 90% and 89% (WHO/DHHS criteria, respectively). In the last observation, after a median follow-up of 127 weeks (91-178), viral suppression was 83.7% and 80.3% (WHO/DHHS) on all 239 cases and 92.5% and 89% among treated cases. Most (69%) had a CD4 >500 cells/mm3, 71.6% if only treated were considered.
Conclusion Newly diagnosed patient at public health service approach the viral suppression target, showing the feasibility of this goal. The high mortality after diagnostic, especially before treatment, warrants to the need to improve the identification and incorporation of this subgroup with advance disease.
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