Are we ending the HIV pandemic in Europe?

From HIV Diagnosis to Virus Suppression: In a quick paper published today in Eurosurveillance, ECDC and its co-authors from Public Health England and the National AIDS Trust summarize the progress made in the field of HIV / AIDS. HIV elimination in 52 countries in Europe and Central Asia. The main problems: diagnose and treat those who are unaware of their HIV infection.

By 2020, UNAIDS aims to diagnose 90% of HIV-positive people, provide antiretroviral therapy to 90% of people diagnosed and remove the virus for 90% of those treated (90-90-90 targets). ). ). In 2018, 52 out of 55 countries responded to the survey, indicating progress towards these goals in Europe and Central Asia.

Between "substantial progress" and "concerning"

Is Europe stopping AIDS by 2020? As a result of the analysis of the data provided by the 52 countries in 2018, the progress made in achieving the 90-90-90 targets are 86% to 91% -92% in the EU / EEA . This means that, overall, the EU / EEA countries are on track to achieve the goals by 2020. However, throughout the region, there is a striking fall the second phase of the continuum: in Europe and Central Asia, the figures show a significant difference in the number of people diagnosed with HIV but who are not receiving treatment: 80% to 64% -86%. The article provides results on the targets for each of the reporting countries.

The authors acknowledge "substantial progress" in achieving the 90-90-90 goals in Europe and Central Asia. However, of the estimated 2.1 million people living with HIV in Europe and Central Asia, "only two out of five people would be repressed by viral violence in 2018". In addition, "the substantial decline between the percentages diagnosed and treated in the Eastern subregion is worrisome because it allows preventable deaths, serious diseases and subsequent transmission".

The results provide new information on the necessary steps of regional or national responses to HIV. While nearly two-thirds of the 1.2 million people infected with the transmissible virus in the region are diagnosed but only half of them are on treatment, "the biggest impact on public health could be achieved by a rapid and sustainable intensification of treatment ", according to the authors. This is especially true for countries in the east of the region where the result was 76% to 46% -78%.

Policies that diversify and improve the availability of HIV testing could help solve the problem of late diagnosis in Europe, as indicated in the ECDC's new guidelines on HIV testing, HIV testing and HIV testing. Hepatitis B and hepatitis C. This would include the testing of indicator conditions, when screening for other sexually transmitted infections, in community settings, as a personal / home test and for partner notification.

The authors point out that goals 90-90-90 remain a "powerful tool for assessing progress toward the elimination of HIV and imposing standards of care" for people living with HIV. But these targets do not provide a complete picture of the public health response to HIV. "Every" 10% "includes particularly marginalized people in health services."

What are the 90-90-90 goals?

The so-called HIV continuum of care is a framework that allows countries to monitor the effectiveness of key areas of the response to the HIV epidemic through several stages, from diagnosis to viral suppression. The general goal is for people living with HIV to be diagnosed (early) and receive antiretroviral therapy (ART) that suppresses the virus, ie the virus is no longer detectable in the blood . An undetectable viral load also means that HIV-positive people under effective treatment do not transmit the virus.

On the basis of the conclusions of the report of the Dublin Declaration of the ECDC on the continuum in 2015, ECDC is now monitoring a four-step continuum that is directly relevant in the European region. Step 1 examines the estimated number of all people living with HIV (PLHIV); stage 2: number of diagnosed PLHIV; Stage 3 at the number of PLHIV diagnosed and on antiretroviral therapy; and stage 4 includes the number of PLHIV on antiretroviral therapy. In 2018, 34 out of 55 countries provided data on the four stages of the continuum.

This article has been republished from documents provided by the European Center for Disease Prevention and Control. Note: Content may have changed for length and content. For more information, please contact the cited source.

Reference
HIV in Europe and Central Asia: progress made in 2018 in achieving UNAIDS goals 90-90-90. Alison E Brown et al. Eurosurveillance, volume 23, number 48, 29 / nov / 2018, http://dx.doi.org/10.2807/1560-7917.ES.2018.23.48.1800622.