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Gasparro G, Trevisan S, Kiros ST, Malcontenti C, Trotta M, Barbiero A, Borchi B, Bartalesi F, Corsi P, Fiorelli C, Sterrantino G, Bartoloni A, Lagi F. UNAIDS 90-90-90 Target and Retention in Care of a Cohort of Migrants Living with HIV in a Tertiary Referral Hospital in Florence, Italy. AIDS Behav 2025:10.1007/s10461-025-04716-9. [PMID: 40327270 DOI: 10.1007/s10461-025-04716-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2025] [Indexed: 05/07/2025]
Abstract
Migrant Living with HIV (MLWH) are facing many barriers. Proposing targeted interventions requires a better understanding of the local epidemiology, but data are scarce. This population often comprises vulnerable groups such as men who have Sex with men and transgender individuals. This single-center cohort study aims to estimate the achievement of the Joint United Nations Programme on HIV/AIDS 90-90-90 goals and the 8-year loss-to-follow-up (LTFU) incidence rate in a cohort of MLWH under treatment at the Infectious and Tropical Diseases Unit of the "Careggi University Hospital", Florence, Italy. We enrolled MLWH taken in care from 01/01/2014 to 31/12/2022. The end of the study was the end of follow-up (30/04/2023) or the date of LTFU (unreachable, relocated to another center, or dead). We enrolled 201 migrants with a median age of 33 [IQR 27-43]. One-hundred-and-six (52.7%) came from Latin America, mainly from Peru (40.2%; n = 81). About a third were transgender women (TW) (32.8%; n = 66). Seventy-six (37.8%) were migrants out-of-status (MOS). HIV was diagnosed in Italy in 58.7% (n = 118). Ninety (44.8%) were treatment-naïve, sex-working was reported in 39 patients (19.4%) before and 55 (27.4%) after migration. One-hundred-thirty-eight (68.7%) were retained in care. The 8-year-LTFU incidence rate was 8.96 per 100 p/y (95% CI 7.0-11.4). MOS had a higher risk of LTFU (aHR 2.68; p = 0.005). Conversely, being a TW (aHR 0.33; p = 0.024) and taking a single-tablet-regimen (aHR 0.44; p = 0.008) were protective factors.In our setting the 90-90-90 targets have not yet been fully achieved, and high rates of LTFU have been observed.
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Affiliation(s)
- Giuseppe Gasparro
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Sasha Trevisan
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Seble Tekle Kiros
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Costanza Malcontenti
- Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy
| | - Michele Trotta
- Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy
| | - Anna Barbiero
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Beatrice Borchi
- Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy
| | - Filippo Bartalesi
- Infectious Diseases Unit, Santa Maria Annunziata Hospital, AUSL Toscana Centro, Bagno a Ripoli, Italy
| | - Paola Corsi
- Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy
| | - Costanza Fiorelli
- Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy
| | - Gaetana Sterrantino
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Alessandro Bartoloni
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
- Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy.
| | - Filippo Lagi
- Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy
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Lagi F, Gatteschi C, Tilli M, Zocco N, Avarello A, Bellini S, Contanessi S, Zigliani MR, Stagnitta M, Mariano L, Gazzarri E, Belloni L, Fisher AD, Bartoloni A, Sterrantino G, Ierardi F. Facilitators and barriers in HIV testing and continuum of care among migrant transgender women who are sex workers residing in Florence, Italy. INTERNATIONAL JOURNAL OF TRANSGENDER HEALTH 2023; 25:268-282. [PMID: 38681492 PMCID: PMC11044723 DOI: 10.1080/26895269.2023.2209072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
Background An increased risk of contracting HIV infection, suboptimal adherence, and a loss to follow-up have been observed in migrants, particularly if those individuals are transgender or sex workers. A clear picture of the HIV epidemic among migrants is complex due to the lack of specific national data. Aims We developed a qualitative study that describes the barriers and facilitators (cultural, social, and personal) in HIV testing and the continuum of care for a group of migrant transgender women who are sex workers. Methods A semi-structured interview was conducted with a group of migrant transgender women who are sex workers living with HIV or with unknown HIV serostatus residing in the Florentine metropolitan area. Results We included 12 participants: 3 had unknown HIV serostatus and 9 were living with HIV in follow-up at the Clinic of Infectious and Tropical Diseases, Careggi University hospiral, Florence, Italy. Among barriers, the perceived stigma due to their identity as migrants and transgender people, the language lack of ability and the legal position in the host country played a significant role. Moreover, the interviewees claimed having no alternative to sex work: for those individuals, changing their lifestyle condition is perceived as difficult or impossible due to social prejudices. Conversely, the interviewees considered support services, such as cultural mediators/interpreters and street units, as facilitators to HIV testing, access to care, and continuum of care. Having regular and accessible ART and the availability of a more consistent health care system, represent reasons for HIV-positive migrants living with HIV to move to Italy. Conclusions Knowledge of this population's personal experience regarding the barriers and factors that facilitate access to the HIV care system is essential for planning public health interventions capable of responding to the real needs of patients.
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Affiliation(s)
- Filippo Lagi
- Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy
| | | | - Marta Tilli
- Department of experimental and clinical medicine, University of Florence, Florence, Italy
| | | | - Angelo Avarello
- Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy
| | - Sabrina Bellini
- Lega Italiana per la Lotta contro l’AIDS, LILA Toscana, Florence, Italy
| | | | | | | | | | | | - Laura Belloni
- Regional Center for Critical Relationships, Careggi University Hospital, Florence, Italy
| | - Alessandra Daphne Fisher
- Andrology, Women’s Endocrinology and Gender Incongruence Unit, Careggi University Hospital, Florence, Italy
| | - Alessandro Bartoloni
- Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy
- Department of experimental and clinical medicine, University of Florence, Florence, Italy
| | - Gaetana Sterrantino
- Department of experimental and clinical medicine, University of Florence, Florence, Italy
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Pennati F, Calza S, Di Biagio A, Mussini C, Rusconi S, Bonora S, Borghetti A, Quiros‐Roldan E, Sarteschi G, Menozzi M, Ferrara M, Celotti A, Ciccullo A, Giacomet V, Izzo I, Dotta L, Badolato R, Castelli F, Focà E. Reduced probability of improving viro-immunological state in subjects with vertical transmission of HIV reaching adult age: A multicenter retrospective cohort study. Immun Inflamm Dis 2023; 11:e778. [PMID: 36840488 PMCID: PMC9910169 DOI: 10.1002/iid3.778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 01/18/2023] [Accepted: 01/19/2023] [Indexed: 02/11/2023] Open
Abstract
INTRODUCTION Young adults with vertical transmission (VT) of human immunodeficiency virus (HIV) represent a fragile population. This study evaluates factors associated with viro-immunological outcome of these patients. METHODS We performed a multicenter study including HIV-infected subjects with VT ≥ 18 years old from six Italian clinics. Subjects were observed from birth to death, lost to follow-up, or last visit until December 31, 2019. Condition of "optimal viro-immunological status" (OS) was defined as the simultaneous presence of HIV ribonucleic acid (RNA) < 50 copies/mL, CD4+ > 500 cells/mm3 , and CD4+/CD8+ ratio ≥ 1. RESULTS A total of 126 subjects were enrolled. At 18 years of age, 52/126 (44.4%) had HIV-RNA > 50 copies/mL, 47/126 (38.2%) had CD4+ < 500/mm3 , and 78/126 (67.2%) had CD4+/CD8+ < 1; 28 subjects (23.7%) presented in the condition of OS. Having a CD4+/CD8+ ratio ≥ 1 at 18 years of age was related with an increased probability of shift from suboptimal viro-immunological status (SOS) to OS (HR: 7.7, 95% confidence interval [CI]: 4.23-14.04), and a reduced risk of shift from the OS to the SOS (HR: 0.49, 95% CI: 0.26-0.92). Acquired immunodeficiency syndrome (AIDS) diagnosis significantly reduced the probability of shift from a viro-immunological SOS to OS (HR: 0.09, 95% CI: 0.03-0.30). Subjects who had not achieved an OS at 18 years of age had an increased risk of discontinuation of combination antiretroviral therapy (cART, p = .019). CONCLUSIONS Only a small proportion of subjects with VT of HIV reached the adult age with "OS". Transition to the adult care with a compromised viro-immunological condition represents a negative driver for future optimal infection control, with a higher risk of discontinuation of cART and a reduced probability to improve the immunological status later in the years.
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Affiliation(s)
- Francesca Pennati
- Unit of Infectious and Tropical DiseasesUniversity of Brescia and ASST Spedali Civili HospitalBresciaItaly
| | - Stefano Calza
- Unit of Biostatistics, Department of Molecular and Translational MedicineUniversity of BresciaBresciaItaly
| | - Antonio Di Biagio
- Clinic of Infectious and Tropical DiseasesUniversity of Genova and “San Martino” HospitalGenoaItaly
| | - Cristina Mussini
- Department of Infectious DiseasesUniversity of Modena and Reggio Emilia and Modena PolyclinicModenaItaly
| | - Stefano Rusconi
- Unit of Infectious DiseasesUniversity of Milano and ASST Fatebenefratelli “L. Sacco” HospitalMilanItaly
| | - Stefano Bonora
- Department of Infectious DiseasesUniversity of Torino and “Amedeo di Savoia” HospitalTurinItaly
| | - Alberto Borghetti
- Infectious Diseases UnitFondazione Policlinico Universitario Agostino Gemelli IRCCSRomeItaly
| | - Eugenia Quiros‐Roldan
- Unit of Infectious and Tropical DiseasesUniversity of Brescia and ASST Spedali Civili HospitalBresciaItaly
| | - Giovanni Sarteschi
- Clinic of Infectious and Tropical DiseasesUniversity of Genova and “San Martino” HospitalGenoaItaly
| | - Marianna Menozzi
- Department of Infectious DiseasesUniversity of Modena and Reggio Emilia and Modena PolyclinicModenaItaly
| | - Micol Ferrara
- Department of Infectious DiseasesUniversity of Torino and “Amedeo di Savoia” HospitalTurinItaly
| | - Anna Celotti
- Unit of Infectious and Tropical DiseasesUniversity of Brescia and ASST Spedali Civili HospitalBresciaItaly
| | - Arturo Ciccullo
- Department of Safety and Bioethics, Section of Infectious DiseasesCatholic University of the Sacred HeartRomeItaly
| | - Vania Giacomet
- Unit of PediatricsUniversity of Milano and ASST Fatebenefratelli “L. Sacco” HospitalMilanItaly
| | - Ilaria Izzo
- Unit of Infectious and Tropical DiseasesUniversity of Brescia and ASST Spedali Civili HospitalBresciaItaly
| | - Laura Dotta
- Unit of PediatricsUniversity of Brescia and ASST Spedali Civili HospitalBresciaItaly
| | - Raffaele Badolato
- Unit of PediatricsUniversity of Brescia and ASST Spedali Civili HospitalBresciaItaly
| | - Francesco Castelli
- Unit of Infectious and Tropical DiseasesUniversity of Brescia and ASST Spedali Civili HospitalBresciaItaly
| | - Emanuele Focà
- Unit of Infectious and Tropical DiseasesUniversity of Brescia and ASST Spedali Civili HospitalBresciaItaly
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Evolution in Real-World Therapeutic Strategies for HIV Treatment: A Retrospective Study in Southern Italy, 2014-2020. J Clin Med 2021; 11:jcm11010161. [PMID: 35011902 PMCID: PMC8745745 DOI: 10.3390/jcm11010161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 12/17/2021] [Accepted: 12/22/2021] [Indexed: 01/03/2023] Open
Abstract
Changes in HIV treatment guidelines over the last two decades reflect the evolving challenges in this field. Our study examined treatment change patterns throughout a 7-year period in a large Italian cohort of HIV patients as well as the reasons and direction of changes. Treatment-naïve and -experienced HIV patients managed by Cotugno Hospital of Naples between 2014 and 2020 were analyzed. During the period, the proportion of single-tablet regimen treatment sharply increased for the naïve and experienced patients. Regimens containing integrase strand transfer inhibitors rapidly replaced those containing protease inhibitor and non-nucleoside reverse transcriptase inhibitors. The use of the tenofovir alafenamide fumarate/emtricitabine backbone increased rapidly after its introduction in the Italian pharmaceutical market, making up 63.7 and 54.9% of all treatments in naïve and experienced patients, respectively, in 2020. The main reason for treatment changes was optimization and/or simplification (90.6% in 2018; 85.3% in 2019; 95.5 in 2020) followed by adverse effects and virological failure. Our real-world analysis revealed that the majority of treatment-naïve and treatment-experienced patients received antiretroviral drugs listed as preferred/recommended in current recommendations. Regimen optimization and/or simplification is a leading cause of treatment modification, while virologic failure or adverse effects are less likely reasons for modification in the current treatment landscape.
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Lagi F, Botta A, Kiros ST, Meli M, Borchi B, Cavallo A, Pozzi M, Bartoloni A, Sterrantino G. Comparison of the efficacy, safety and durability of a switch to co-formulated RPV/TDF-TAF/FTC or DTG/ABC/3TC in virologically-suppressed HIV-1-infected patients in a single Italian centre: a cohort data analysis. Int J Antimicrob Agents 2021; 59:106465. [PMID: 34699933 DOI: 10.1016/j.ijantimicag.2021.106465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 10/01/2021] [Accepted: 10/09/2021] [Indexed: 11/17/2022]
Abstract
This study evaluated the efficacy, safety and durability of a switch to co-formulated RPV/TDF-TAF/FTC (RPV-STR) or DTG/ABC/3TC (DTG-STR) in virologically-suppressed HIV-positive patients in a single Italian centre. All HIV-infected ART-experienced patients switching to RPV-STR or DTG-STR with HIV-RNA <50 copies/mL were included. Outcomes were incidence rate and rate ratios for discontinuation due to all causes (DAC), to adverse events (DAE) and to virological failure (VF) after 4 years of follow-up. We included 402 patients (244 on RPV-STR, 158 on DTG-STR). At Year 4 of follow-up, 124 patients (30.8%) discontinued for any cause (71 on RPV-STR, 53 on DTG-STR). Fifteen patients experienced VF [13 (5.3%) on RPV-STR and 2 (1.3%) on DTG-STR; log-rank, P = 0.4413]. Overall, 46 patients (11.4%) had AEs (23 on RPV-STR, 23 on DTG-STR). Nausea/diarrhoea was more frequent with DTG-STR (4.4% vs. 0%) and neurological toxicity with RPV-STR (4.5% vs. 2.5%). The rate of DAC within the first 3 months was significantly higher with DTG-STR (aRR = 5.88, 95% CI 3.20-10.81; P < 0.001); similarly, the discontinuation rate due to AEs was significantly higher with DTG-STR compared with RPV-STR (aRR = 12.89, 95% CI 5.48-30.32; P < 0.001). No difference in VF was observed between the two groups (RR = 0.47, 95% CI 0.10-2.14; P = 0.335). Patients with undetectable viral load who switched to DTG-STR or RPV-STR maintained virological suppression with a low risk of VF. A higher discontinuation rate was observed with DTG-STR compared with RPV-STR, particularly within 3 months from switch.
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Affiliation(s)
- Filippo Lagi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy
| | - Annarita Botta
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Seble Tekle Kiros
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Massimo Meli
- Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy
| | - Beatrice Borchi
- Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy
| | - Annalisa Cavallo
- Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy
| | - Marco Pozzi
- Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy
| | - Alessandro Bartoloni
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy
| | - Gaetana Sterrantino
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
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De Socio GV, Pasqualini M, Ricci E, Maggi P, Orofino G, Squillace N, Menzaghi B, Madeddu G, Taramasso L, Francisci D, Bonfanti P, Vichi F, dell'Omo M, Pieroni L. Smoking habits in HIV-infected people compared with the general population in Italy: a cross-sectional study. BMC Public Health 2020; 20:734. [PMID: 32434482 PMCID: PMC7238525 DOI: 10.1186/s12889-020-08862-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 05/06/2020] [Indexed: 12/14/2022] Open
Abstract
Background Tobacco use is a leading cause of preventable diseases and death for all individuals, even more so for people living with HIV (PLWH), due to their status of chronic inflammation. To date, in Italy no study was performed to compare smoking habits in PLWH and the general population. We aimed to investigate smoking habits in PLWH, as compared to the general population. Methods Multi-center cross-sectional study. Smoking habits were compared between PLWH and the general population. PLWH were enrolled in the STOPSHIV Study. The comparison group from the general population was derived from a survey performed by the National Statistics Institute (ISTAT), with a stratified random sampling procedure matching 2:1 general population subjects with PLWH by age class, sex, and macro-area of residence. Results The total sample consisted of 1087 PLWH (age 47.9 ± 10.8 years, male 73.5%) and 2218 comparable subjects from the general population. Prevalence of current smokers was 51.6% vs 25.9% (p < 0.001); quitting smoking rate was 27.1% vs. 50.1% (p < 0.001) and the mean number of cigarettes smoked per day was 15.8 vs. 11.9 (p < 0.001), respectively for PLWH and the general population. Smoking and heavy smoking rates amongst PLWH were significantly higher even in subjects who reported diabetes, hypertension and extreme obesity (p < 0.001). Logistic regressions showed that PLWH were more likely current smokers (adjusted Odds Ratio, aOR = 3.11; 95% Confidence Interval (CI) =2.62–3.71; p < 0.001) and heavy smokers (> 20 cigarettes per day) (aOR = 4.84; 95% CI = 3.74–6.27; p < 0.001). PLWH were less likely to have quitted smoking (aOR = 0.36; 95% CI = 0.29–0.46; p < 0.001). Conclusion HIV-infected patients showed a higher rate of current smokers, a larger number of cigarettes smoked and a lower quitting rate than the general population. Our findings emphasize the need for smoking cessation strategies targeting HIV persons.
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Affiliation(s)
- Giuseppe Vittorio De Socio
- Department of Medicine 2, Infectious Diseases Unit, Azienda Ospedaliera di Perugia and University of Perugia, Santa Maria Hospital, Perugia, Italy. .,Current Address: Azienda Ospedaliera di Perugia, Piazzale Menghini 1, 06129, Perugia, Italy.
| | - Marta Pasqualini
- Department of Political Science, University of Perugia, Perugia, Italy
| | - Elena Ricci
- Department of Woman, Newborn and Child, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Paolo Maggi
- Infectious Diseases Clinic, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Giancarlo Orofino
- Division I Infectious and Tropical Diseases, ASL Città di Torino, Turin, Italy
| | - Nicola Squillace
- Infectious Diseases Unit ASST-MONZA, San Gerardo Hospital-University of Milano-Bicocca, Monza, Italy
| | - Barbara Menzaghi
- Infectious Diseases Unit, ASST della Valle Olona - Busto Arsizio (VA), Busto Arsizio, Italy
| | - Giordano Madeddu
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Lucia Taramasso
- Department of Health Science (DISSAL), Infectious Disease Clinic, University of Genova, Genoa, Italy.,Infectious Diseases Unit, Department of Internal Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Daniela Francisci
- Department of Medicine 2, Infectious Diseases Unit, Azienda Ospedaliera di Perugia and University of Perugia, Santa Maria Hospital, Perugia, Italy
| | - Paolo Bonfanti
- Infectious Diseases Unit, A. Manzoni Hospital, Lecco, Italy
| | - Francesca Vichi
- Infectious Diseases Unit, Santa Maria Annunziata Hospital, USL Centro, Florence, Italy
| | - Marco dell'Omo
- Department of Medicine, Perugia University, Perugia, Italy
| | - Luca Pieroni
- Current Address: Azienda Ospedaliera di Perugia, Piazzale Menghini 1, 06129, Perugia, Italy
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Schiaroli E, De Socio GV, Gabrielli C, Papalini C, Nofri M, Baldelli F, Francisci D. Partial Achievement of the 90-90-90 UNAIDS Target in a Cohort of HIV Infected Patients from Central Italy. Mediterr J Hematol Infect Dis 2020; 12:e2020017. [PMID: 32180912 PMCID: PMC7059746 DOI: 10.4084/mjhid.2020.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 02/14/2020] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Despite progress in the prevention and treatment of HIV, persistent issues concerning the evaluation of continuum in care from the serological diagnosis to virologic success remains. Considering the 2020 UNAIDS target 90-90-90 for diagnosis, treatment, and viral suppression of people living with HIV (PLWH), our purpose was to verify if, starting from new diagnoses, the viral suppression rate of our cohort of new PLWH satisfied the second and the third steps. METHODS This retrospective study regards all patients aged ≥15 undergoing HIV test at our clinic between January 2005 and December 2017. We evaluated the second and the third '90 UNAIDS targets and the unclaimed tests, linkage to care, retention in ART, and the viral suppression at 1 and 2 years. Logistic regression (odds ratio, 95% confidence interval) was performed. RESULTS We observed 592 new diagnoses for HIV infection: 61.4% on Italians, 38.5% on foreigners. An antiretroviral treatment was started on 78.8% of the new diagnoses (467/592) (second UNAIDS target), and a viral suppression was obtained at 2 years on 82% of PLWH who had started ART (383/467) (third UNAIDS target), namely only 64.7% of the new diagnoses instead of the hoped-for 81% of the UNAIDS target. Logistic regressions demonstrated that second and third '90 UNAIDS targets were unrelated to sex, nationality, CD4 cells count, HIV-RNA and CDC stage (p>0.05). The age class 25-50 years (OR=2.24; 95% CI = 1.06-4.37; p=0.04) achieves more likely viral suppression when compared with patients <25 years. Considering the continuum of care, 88 (15%) PLWH were lost to engagement in care (55 unclaimed tests and 33 unlinked to care), 37 didn't start ART, 51 were LFTU at 2 years. CONCLUSIONS UNAIDS goal was far to be reached. The main challenges were unreturned tests as well as the retention in ART. Rapid tests for a test-treat strategy and frequent phone communications in the first ART years could facilitate UNAIDS target achievement.
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Affiliation(s)
- Elisabetta Schiaroli
- Clinic of Infectious Diseases, Department of Medicine, University of Perugia, Perugia, Italy
| | | | - Chiara Gabrielli
- Clinic of Infectious Diseases, Department of Medicine, University of Perugia, Perugia, Italy
| | - Chiara Papalini
- Clinic of Infectious Diseases, Department of Medicine, University of Perugia, Perugia, Italy
| | - Marco Nofri
- Clinic of Infectious Diseases, Department of Medicine, University of Perugia, Perugia, Italy
| | - Franco Baldelli
- Clinic of Infectious Diseases, Department of Medicine, University of Perugia, Perugia, Italy
| | - Daniela Francisci
- Clinic of Infectious Diseases, Department of Medicine, University of Perugia, Perugia, Italy
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