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AMSTERDAM – African communities that have adopted a "test-and-treat" strategy for several diseases have achieved greater reductions in the incidence of HIV compared to other communities that treat patients according to national guidelines according to researchers
. After three years in which multiple tests were conducted at events such as community health fairs in rural Uganda and Kenya, mortality declined by 21%. In addition, tuberculosis cases decreased by 59% compared to reference communities, the population-level hypertension was reduced by 26% and the suppression of HIV increased from 32% to 80%, reported Diane Havlir, MD. At a press conference at the International AIDS Conference, she said that one of the keys to the study's success of 350,000 people was the decision to quickly treat patients when health problems
"I think our findings mean that a multi-disease approach to HIV testing is a successful model that people can use, which can accelerate the reduction of mortality and reduce TB, and is badociated with a reduction in the incidence of HIV.But this has not eliminated all HIV infections, so we still need programs along this multi-disease and multi-funded approach. "
" We asked if this approach could reduce the incidence of HIV and improve health, Havlir continued. "The vehicle for the intervention was health fairs, where we offered testing. for HIV, diabetes, diabetes, & # 39; hypertension, malaria tests and other health services well designed and very well received by the community. 1 year after the intervention, the team quickly increased HIV services and reached "90-90-90", that is, the goal of the United Nations Program on HIV / AIDS is to identify 90% of people infected with HIV. % of these patients in treatment, and get 90% of treated patients to achieve undetectable viral loads.
"We were able to do it very, very quickly, and at the end of the 3 years our overall viral load suppression – including those who migrated – was 79% and 10% higher for people we started with, "said Havlir. "We also showed that during the study in the communities where the intervention took place, the annual incidence of HIV decreased by 30%."
The incidence decreased similarly in both branches of the study. Linda-Gail Bekker, Ph.D., President of the International AIDS Society, commented, "These are very important data from the world-renowned SEARCH study that we really need to commend. and researchers in Africa, who have done really impressive studies and presented important data here. "
The success of the test-and-treat approach was not isolated in the villages of Kenya and Uganda." In a national program conducted at eSwatini – the little formerly known kingdom as Swaziland – similar results have been achieved, said Velepi Okello, MD, deputy director of clinical services of the eSwatini Ministry of Health, at the press conference.The nation has embarked on a universal screening and treatment program , she said, essentially offering services to all in this landlocked country located along the border between South Africa and Mozambique and led by the only absolute monarch in Africa, King Mswati III. , which governs more than 1.34 million people.
People infected with HIV were immediately put on antiretroviral therapy, said Okello. The small country had an HIV incidence rate of 31 % in adults aged 18 to 49 years in 2011, requiring government action, and since then, HIV incidence rates have dropped by 44%.
Patients were enrolled in a randomized slanted stepped design. In the standard protocol, the program enrolled 2,034 patients and 1,371 patients received early antiretroviral therapy. After one year, 86% of patients in the intervention group were still retained, compared to 80% of patients receiving standard treatment ( P <0.005), which was the primary outcome of the treatment group. interim evaluation study.
"The MaxART study shows that early antiretroviral therapy is acceptable, feasible and affordable and improves the health and well-being of people living with HIV," said Mr. Okello. "This study proves that treatment as prevention does not only work in a research setting but also on a large scale in real life."
She pointed out that the improvement in retention was no increase in health costs. SEARCH's study is Gilead
Havlir and Okello reported to have no relevant relationship with the industry.
2018-07-27T11: 30: 00-0400
