Human immunodeficiency virus cascade–continuum of care stages and outcomes in a hospital in southern Brazil  

作　　者：Manoela Badinelli Vaucher Patrícia Fisch Dimas Alexandre Kliemann 

机构地区：[1]Department of Hepatology,Universidade Federal de Ciências da Saúde de Porto Alegre,Porto Alegre 90050-170,Rio Grande do Sul,Brazil [2]Department of Medicine,Universidade do Vale do Taquari(UNIVATES),Lajeado 95914-014,Rio Grande do Sul,Brazil [3]Department of Life Sciences,Universidade de Santa Cruz do Sul(UNISC),Santa Cruz do Sul 96815-900,Rio Grande do Sul,Brazil [4]Department of Medicine,Pontifícia Universidade Católica do Rio Grande do Sul,Porto Alegre 90619-900,Rio Grande do Sul,Brazil [5]Department of Epidemiology,Hospital Nossa Senhora da Conceição,Porto Alegre 91350-250,Rio Grande do Sul,Brazil [6]Department of Infectious Disease,Hospital Nossa Senhora da Conceição,Porto Alegre 91350-250,Rio Grande do Sul,Brazil

出　　处：《World Journal of Virology》2024年第3期65-75,共11页世界病毒学杂志

摘　　要：BACKGROUND The human immunodeficiency virus(HIV)continuum of care cascade illustrates the 90-90-90 goals defined by the Joint United Nations Program on HIV/acquired immunodeficiency syndrome(UNAIDS).The care cascade includes the following five steps:Diagnosis,linkage to care,retention in care,adherence to antiretroviral therapy(ART),and viral suppression.AIM To elaborate the HIV cascade of patients diagnosed with HIV at the Nossa Senhora da Conceição Hospital(HNSC)and to determine possible local causes for the loss of patients between each step of the cascade.METHODS This retrospective cohort study included patients diagnosed with HIV infection from January 1,2015 to December 31,2016 and followed up until July 31,2019.The data were analyzed by IBM SPSS software version 25,and Poisson regression with simple robust variance was used to analyze variables in relation to each step of the cascade.Variables with P<0.20 were included in multivariable analysis,and P<0.05 was considered significant.Pearson’sχ^(2) test was used to compare the groups of patients followed up at the HNSC and those followed up at other sites.RESULTS The results were lower than those expected by the UNAIDS,with 94%of patients linked,91%retained,81%adhering to ART,and 84%in viral suppression.Age and site of follow-up were the variables with the highest statistical significance.A comparison showed that the cascade of patients from the HNSC had superior results than outpatients,with a significant difference in the last step of the cascade.CONCLUSION The specialized and continued care provided at the HNSC was associated with better results and was closer to the goals set by the UNAIDS.The development of the HIV cascade using local data allowed for the stratification and evaluation of risk factors associated with the losses occurring between each step of the cascade.

关 键 词：CASCADE Continuum care Human immunodeficiency virus Antiretroviral therapy ADHERENCE 

分 类 号：R512.91[医药卫生—内科学]