Adherence to antiretroviral treatment and viral suppression among patients at Unicamp's Hospital de Clínicas: seeking the UNAIDS goal 90-90-90

Authors

DOI:

https://doi.org/10.33448/rsd-v10i13.21428

Keywords:

HIV; AIDS; Sustained Virologic Response; Antiretroviral Therapy, Highly Active; Coinfection.

Abstract

Objective: to verify adherence to antiretroviral treatment and viral suppression, according to demographic, clinical and laboratory variables in patients seen at the HIV/AIDS outpatient clinic of HC-Unicamp in 2016. Method: cross-sectional study on the demographic, epidemiological and clinical profile of patients treated at the Outpatient Clinic of Infectious Diseases at Hospital Dia of the State University of Campinas Hospital de Clínicas to assess adherence to ART and any adverse events recorded in 2016. Results: of the 339 medical records sampled from PLWHA, 278 (82.0%) with regular use of antiretrovirals and 293 (86.4%) with undetectable viral load (<40 copies / mL). The multiple logistic models, age, clinical complications, and side effects of medications are associated with lower adherence to ART. Viral suppression was more significant among men, with older age and shorter diagnosis time, and less frequent in patients with clinical complications and adverse effects of the medication. Conclusion:  a greater integration between services can facilitate the rescue of PLWHA without clinical follow-up. The clinical management of complications and adverse drug events are relevant to treatment adherence and viral suppression in patients attending the services.

References

Abdulrahman, S. A., Ganasegeran, K., Rampal, L. & Martins, O. F. (2019). HIV Treatment Adherence - A Shared Burden for Patients, Health-Care Providers, and Other Stakeholders. AIDS Reviews, 21(1), 28-39. https://pubmed.ncbi.nlm.nih.gov/30899114/

Camargo, C. C., Cavassan, N. R. V., Tasca, K. I., Meneguin, S., Miot, H. A. & Souza, L. R. (2019). Depression and Coping Are Associated with Failure of Adherence to Antiretroviral Therapy Among People Living with HIV/AIDS. AIDS Research and Human Retroviruses, 35(11-12), 1181-1189. https://pubmed.ncbi.nlm.nih.gov/31592722/

Detsis, M., Tsioutis, C., Karageorgos, S. A., Sideroglou, T., Hatzakis, A. & Mylonakis, E. (2017). Factors Associated with HIV Testing and HIV Treatment Adherence: A Systematic Review. Current Pharmaceutical Design, 23(18), 2568-2578. https://pubmed.ncbi.nlm.nih.gov/28356038/

Gardner, E. M., McLees, M. P., Steiner, J. F., Del Rio, C., & Burman, W. J. (2011). The spectrum of engagement in HIV care and its relevance to test-and-treat strategies for prevention of HIV infection. Clinical Infectious Diseases, 52(6), 793-800. https://pubmed.ncbi.nlm.nih.gov/21367734/

Guibu, I. A., Barros, M. B., Donalisio, M. R., Tayra, A. & Alves, M. C. (2011). Survival of AIDS patients in the Southeast and South of Brazil: analysis of the 1998-1999 cohort. Cadernos de Saúde Pública, 27(Suppl), 1:S79-92. https://www.scielo.br/j/csp/a/hcyPQmmqZ6bQbRdWpFLGqJN/?lang=en

Horberg, M. A., Silverberg, M. J., Hurley, L. B., Towner, W. J., Klein, D. B., Bersoff-Matcha, S., Weinberg, W. G., Antoniskis, D., Mogyoros, M., Dodge, W. T., Dobrinich, R., Quesenberry, C. P. & Kovach, D. A. (2008). Effects of depression and selective serotonin reuptake inhibitor use on adherence to highly active antiretroviral therapy and on clinical outcomes in HIV-infected patients. Journal of Acquired Immune Deficiency Syndromes, 47, 384–90. https://pubmed.ncbi.nlm.nih.gov/18091609/

Jalil, E. M., Wilson, E. C., Luz, P. M., Velasque, L., Moreira, R. I., Castro, C. V., Monteiro, L., Garcia, A. C., Cardoso, S. W., Coelho, L., McFarland, W., Liu, A. y., Veloso, V. G., Buchbinder, S. & Grinsztejn, B. (2017). HIV testing and the care continuum among transgender women: population estimates from Rio de Janeiro, Brazil. Journal of the International AIDS Society, 20, 21873. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5640309/

Knoll, R. K., Maeyama, M. A., Schmidlin, P. C. & Branchi, T. L. (2019). Práticas de uma equipe multiprofissional para pessoas vivendo com hiv/aids: um estudo de caso em um município da Foz do Rio Itajaí-açu, Santa Catarina-Brasil. Arquivos Catarinenses de Medicina, 48(4), 02-15. http://www.acm.org.br/acm/seer/index.php/arquivos/article/view/381

Loch, A. P., Caraciolo, J. M. M., Rocha, S. Q., Fonsi, M., Souza, R. A., Gianna, M. C., Gonçalves, M. C. & Kalichman, A. O. (2020). An intervention for the implementation of clinical monitoring in specialized care services to people living with HIV/AIDS. Cadernos de Saúde Pública, 36(5), e00136219. https://www.scielo.br/j/csp/a/6FMHztrWVQZ8wfWxnC9qn8s/abstract/?lang=en

Melo, M. C., Donalisio., M. R. & Cordeiro, R. C. (2017). Sobrevida de pacientes com AIDS e coinfecção pelo bacilo da tuberculose nas regiões Sul e Sudeste do Brasil. Ciência & Saúde Coletiva, 22(11), 3781-3792. https://doi.org/10.1590/1413-812320172211.26352015

Ministério da Saúde (2017a). Prevenção Combinada do HIV. Bases conceituais para profissionais, trabalhadores(as) e gestores(as) de saúde. p. 123. http://www.aids.gov.br/pt-br/pub/2017/prevencao-combinada-do-hiv-bases-conceituais-para-profissionais-trabalhadoresas-e-gestores

Ministério da Saúde (2017b). Nota Informativa Nº007/2017 - DDAHV/SVS/MS. http://www.aids.gov.br/pt-br/legislacao/nota-informativa-no-0072017-ddahv-svs-ms

Ministério da Saúde. (2018). Protocolo clínico e diretrizes terapêuticas para manejo da infecção pelo HIV em adultos. http://www.aids.gov.br/pt-br/pub/2013/protocolo-clinico-e-diretrizes-terapeuticas-para-manejo-da-infeccao-pelo-hiv-em-adultos

Ministério da Saúde. (2019). Relatório de monitoramento clínico do HIV. https://www.gov.br/saude/pt-br/centrais-de-conteudo/publicacoes/publicacoes-svs/aids/relatorio_de_monitoramento_clinico_aids.pdf

Morettin, P. A. (2010). Estatística Básica. Saraiva.

Murray, J. F. (1991). Tuberculosis and human immunodeficiency virus infection during the 1990's. Bulletin of the International Union Against Tuberculosis and Lung Disease, 66(1), 21-25. https://pubmed.ncbi.nlm.nih.gov/1859939/

Remor, E., Penedo, F. J., Shen, B. J. & Schneiderman, N. (2007). Perceived stress is associated with CD4+ cell decline in men and women living with HIV/AIDS in Spain. AIDS Care, 19(2), 215-9. https://pubmed.ncbi.nlm.nih.gov/17364401/

Silva, L.A.V., Duarte, F.M. & Lima, M. (2020). Modelo matemático pra uma coisa que não é matemática: narrativas de médicos/as infectologistas sobre carga viral indetectável e intransmissibilidade do HIV. Physis: Revista de Saúde Coletiva, 30(01), e300105. https://doi.org/10.1590/S0103-73312020300105

UNAIDS (2014). 90–90–90: An ambitious treatment target to help end the AIDS epidemic. Joint United Nations Programme on HIV/AIDS. https://www.unaids.org/sites/default/files/media_asset/90-90-90_en.pdf

UNAIDS (2020). Joint United Nations Programme on HIV/AIDS Seizing the moment, tackling entrenched inequalities to end epidemics. https://www.aidsdatahub.org/resource/2020-global-aids-update-seizing-moment-tackling-entrenched-inequalities-end-epidemics.

Published

17/10/2021

How to Cite

MELO, M. C. de; POLILLO FILHO, F. E. .; MORENO, F. F. .; BÜHL, C. N. .; DONALISIO, M. R. Adherence to antiretroviral treatment and viral suppression among patients at Unicamp’s Hospital de Clínicas: seeking the UNAIDS goal 90-90-90. Research, Society and Development, [S. l.], v. 10, n. 13, p. e395101321428, 2021. DOI: 10.33448/rsd-v10i13.21428. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/21428. Acesso em: 22 nov. 2024.

Issue

Section

Health Sciences