Analysis of the main epidemiological indicators of HIV infection and results of multi-year application of antiretroviral therapy (by the materials from the North-West of Russia)

Abstract

The aim of the work is to analyze the effect of ongoing antiretroviral therapy on indicators characterizing the epidemic process of HIV infection.

Material and methods. In the course of the analysis, generalized statistical materials were used for the North-West Federal District and its regions: Vologda, Leningrad and Novgorod Regions (2005-2018). The obtained statistical materials and data from the annual reports were generalized and analyzed on the basis of the Saint-Petersburg Pasteur Institute of the Federal Service for Supervision of Consumer Rights Protection and Human Welfare. The epidemiological database included 136,359 HIV-infected patients, 4 1081 patients with HIV infection, and antiretroviral therapy was carried out.

Results and discussion. In the Russian Federation, antiretroviral therapy for patients with HIV infection has been used for 14 years and covers 38.4% of the total number of people living with HIV in the Northwestern Federal District and 61.6% of the number of patients registered in the dispensary. Over the past period, there was no significant effect of antiretroviral therapy on the epidemic situation of HIV infection, which can be judged by the number of newly detected cases of HIV infection and the increase in the proportion of patients undergoing clinical manifestations, which increased from 11.3 to 63.1%.

At the same time, the effectiveness of antiretroviral prophylaxis of perinatal transmission of HIV from infected mothers to newborns was noted.

Conclusion. An analysis of the indicators characterizing the epidemic process of HIV infection in the Northwestern Federal District and its individual subjects, taking into account the level of ART coverage, indicates that with the achieved level of ART there were no pronounced changes in the manifestations of the HIV epidemic process: there is no stabilization of the incidence and prevalence of HIV infections; there remains a tendency to identify and register new cases of HIV infection at advanced stages of the disease (severe and comorbid forms of HIV infection); no decrease in mortality from HIV infection was detected.

Most likely, this was due to the ongoing ART program, in the framework of which negative factors could occur that reduce or limit the effectiveness of ART. Among these factors, first of all, it should be noted the prevailing use of antiretroviral drugs of the first generations and low-quality generics, and low coverage of PLHIV treatment. To obtain convincing results of the impact of ART on the development of the epidemic process of HIV infection, it is necessary to eliminate a number of negative factors - social, territorial, organizational, clinical and, most importantly, pharmaceutical problems.

Keywords:HIV-infection, HIV epidemic situation, the people living with HIV, antiretroviral therapy, HIV incidence, HIV prevalence, mortality

Funding. The study had no sponsor support.

Conflict of interests. The authors declare no conflict of interests.

For citation: Belyakov N.A., Ogurtsova S.V., Azovtseva O.V., Kurganova T.Yu., Melnikova T.N., Leonova O.N., Stepanova E.V., Kovele-nov A.Yu., Asadullayev M.R., Rassokhin V.V. Analysis of the main epidemiological indicators of HIV infection and results of multiyear application of antiretroviral therapy (by the materials from the North-West of Russia). Infektsionnye bolezni: novosti, mneniya, obuchenie [Infectious Diseases: News, Opinions, Training]. 2020; 9 (1): 19-27. doi: https://doi.org/10.33029/2305-3496-2020-9-1-19-27 (in Russian)

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CHIEF EDITOR
Aleksandr V. Gorelov
Academician of the Russian Academy of Sciences, MD, Head of Infection Diseases and Epidemiology Department of the Scientific and Educational Institute of Clinical Medicine named after N.A. Semashko ofRussian University of Medicine, Ministry of Health of the Russian Federation, Professor of the Department of Childhood Diseases, Clinical Institute of Children's Health named after N.F. Filatov, Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation, Deputy Director for Research, Central Research Institute of Epidemiology, Rospotrebnadzor (Moscow, Russian Federation)

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