Virologic success under antiretroviral therapy among people living with HIV/AIDS in the state of Paraná, Brazil

Dias, Frederico Alves; Höfelmann, Doroteia Aparecida; Rattmann, Yanna Dantas

doi:10.31744/einstein_journal/2021AO5800

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Original Article • Einstein (São Paulo) 19 • 2021 • https://doi.org/10.31744/einstein_journal/2021AO5800 copy

Virologic success under antiretroviral therapy among people living with HIV/AIDS in the state of Paraná, Brazil

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To characterize the sociodemographic profile of the population undergoing antiretroviral treatment in the state of Paraná, Brazil, to investigate the proportion of people undergoing treatment among all those diagnosed, and to analyze the proportion of patients with suppressed viral load in different regions of the state.

Methods:

Observational descriptive and analytical study carried out with information referring to the period from January 2018 to January 2019. Data were obtained from the Sistema Informatizado de Monitoramento Clínico das Pessoas Vivendo com HIV/AIDS [Computerized System for Clinical Monitoring of People Living with HIV/AIDS] and Sistema de Controle Logístico de Medicamentos[Drug Supply Control System]. The proportion of people on antiretroviral treatment in the state and the proportion of patients with viral load ≤1,000 copies/mL and ≤50 copies/mL were calculated. The results were compared with the corresponding parameters of the World Health Organization goal 90-90-90.

Results:

The state of Paraná managed to reach the second and third parameters of the 90-90-90 goal of the World Health Organization. Among those diagnosed, 93.12% were on antiretroviral treatment, and 90.0% of them had a viral load below 50 copies of viral RNA/mL of blood, indicating virologic success.

Conclusion:

The health policy aimed at the population living with HIV/AIDS, and the health services available in Paraná have been successful in parameters relevant to the control of the epidemic. However, it is necessary to ensure the diagnosis of people infected with HIV in the population.

Keywords:
HIV; AIDS; Anti-retroviral agents; Health profile; Sustained virologic response

Variables		n (%)
Sex
	Male	19,241 (60.0)
	Female	12,822 (40.0)
	Not reported	33 (0.1)
Age group, years
	<5	1,069 (3.3)
	5-19	650 (2.0)
	20-29	5,083 (15.8)
	30-39	7,651 (23.8)
	40-49	8,250 (25.7)
	50-59	6,221 (19.4)
	>60	3,172 (9.9)
Skin color
	White	19,783 (61.6)
	Brown	5,112 (15.9)
	Black	1,403 (4.7)
	Yellow	140 (0.4)
	Indigenous	31 (0.1)
	Not reported	5,627 (17.5)
Education, years
	None	1,569 (4.9)
	1-3	2,211 (6.9)
	4-7	8,147 (25.4)
	8-11	8,285 (25.8)
	or more	3,985 (12.4)
	Not reported	7,899 (24.6)
Total		32,096 (100.0)

Regional Health Division (RS)	2018 (%)						2019 (%)	Coefficient	95%CI	p value	Variation (%)	95%CI	Interpretation
Regional Health Division (RS)	January	March	May	July	September	November	January	Coefficient	95%CI	p value	Variation (%)	95%CI	Interpretation
1^st Paranaguá	87.7	87.8	88.3	92.0	92.3	93.5	94.4	1.38	0.9-1.8	0.001	3.55	2.86-4.24	Increase
2^nd Metropolitana de Curitiba	92.2	91.8	92.5	94.9	95.1	96.1	96.9	1.00	0.7-1.3	<0.001	2.48	2.06-2.90	Increase
3^rd Ponta Grossa	89.0	89.0	88.8	91.2	92.0	93.2	95.6	1.46	0.9-2.0	0.002	3.66	2.77-4.55	Increase
4^th Irati	94.5	93.3	91.4	94.9	94.5	95.0	95.9	0.61	-0.0-1.2	0.055	1.51	0.54-2.49	Stability
5^th Guarapuava	87.5	88.2	88.5	92.1	93.5	94.2	94.7	1.46	0.9-2.0	0.002	3.74	2.78-4.72	Increase
6^th União da Vitória	87.0	86.5	87.0	92.6	92.1	94.7	95.6	1.89	1.3-2.5	0.001	4.91	3.94-5.89	Increase
7^th Pato Branco	86.3	86.1	85.4	90.4	91.3	93.8	94.8	1.95	1.2-2.7	0.002	5.11	3.94-6.30	Increase
8^th Francisco Beltrão	91.7	91.4	92.2	93.5	93.9	95.7	97.2	1.23	0.8-1.6	0.001	2.98	2.40-3.56	Increase
9^th Foz do Iguaçu	92.1	91.6	92.8	94.4	94.9	96.3	97.1	1.05	0.9-1.2	<0.001	2.59	2.41-2.77	Increase
10^th Cascavel	91.9	91.4	92.0	93.8	93.6	93.5	96.9	0.72	0.4-1.0	0.004	1.80	1.29-2.31	Increase
11^th Campo Mourão	88.2	87.9	88.1	91.8	92.5	93.9	94.0	1.38	0.8-1.9	0.002	3.55	2.71-4.40	Increase
12^th Umuarama	90.4	89.9	91.0	94.7	94.7	95.2	95.7	1.18	0.5-1.8	0.008	2.97	1.91-4.04	Increase
13^th Cianorte	76.8	77.0	80.2	90.2	87.6	88.2	91.9	2.75	0.7-4.7	0.019	7.81	4.1-11.6	Increase
14^th Paranavaí	92.5	92.6	92.9	95.0	93.6	94.6	97.5	0.67	0.2-1.1	0.011	1.65	1.0-2.3	Increase
15^th Maringá	91.1	91.2	92.6	94.0	93.3	94.0	96.5	0.79	0.4-1.2	0.004	1.98	1.4-2.6	Increase
16^th Apucarana	85.5	84.7	84.9	90.1	89.9	91.6	95.2	1.95	1.3-2.6	0.001	5.17	4.1-6.2	Increase
17^th Londrina	89.8	89.4	89.9	92.0	93.0	93.5	95.8	1.23	0.9-1.5	<0.001	3.11	2.6-3.6	Increase
18^th Cornélio Procópio	84.8	84.9	83.7	87.1	85.9	89.9	93.2	1.86	0.4-3.3	0.023	4.83	2.6-7.1	Increase
19^th Jacarezinho	83.2	82.7	82.4	89.5	89.0	90.2	92.9	2.02	1.2-2.9	0.003	5.51	4.0-7.0	Increase
20^th Toledo	86.5	85.6	86.5	88.8	87.6	91.3	94.0	1.61	0.7-2.5	0.007	4.16	2.8-5.5	Increase
21^st Telêmaco Borba	85.4	85.5	86.6	89.0	88.6	88.7	89.5	0.72	0.1-1.3	0.028	1.91	0.9-2.9	Increase
22^nd Ivaiporã	84.8	83.6	84.2	88.5	88.9	91.7	93.6	2.05	1.5-2.6	<0.001	5.46	4.6-6.3	Increase
City Administration of Curitiba	94.9	94.5	94.9	95.8	96.1	96.7	97.7	0.65	0.5-0.8	<0.001	1.56	1.3-1.8	Increase
Paraná	91.4	91.1	91.6	93.8	94.0	94.9	96.4	1.01	0.8-1.2	<0.001	2.52	2.1-2.9	Increase

Regional Health Division (RS)	2018 (%)						2019 (%)	Coefficient	95%CI	p value	Variation (%)	95%CI	Interpretation
Regional Health Division (RS)	January	March	May	July	September	November	January	Coefficient	95%CI	p value	Variation (%)	95%CI	Interpretation
1^st Paranaguá	82.6	82.0	81.8	85.8	86.4	88.0	89.4	1.56	1.1-2.1	0.001	4.30	3.4-5.2	Increase
2^nd Metropolitana de Curitiba	86.0	85.7	86.7	90.3	90.7	92.2	93.2	1.53	1.1-1.9	<0.001	4.02	3.3-4.7	Increase
3^rd Ponta Grossa	82.2	81.7	81.3	85.5	86.7	88.3	91.5	2.08	1.4-2.8	0.001	5.68	4.5-6.9	Increase
4^th Irati	89.0	86.7	85.0	87.7	87.6	87.1	89.8	0.67	-0.1-1.5	0.081	1.77	0.5-3.1	Stability
5^th Guarapuava	78.8	78.8	79.9	83.3	86.0	87.7	88.1	2.07	1.4-2.7	0.001	5.88	4.7-7.0	Increase
6^th União da Vitória	80.7	79.7	80.3	84.3	82.5	87.3	92.9	2.74	0.9-4.6	0.014	7.27	4.4-10.2	Increase
7^th Pato Branco	77.9	78.6	78.2	83.3	84.4	89.0	89.9	2.54	1.8-3.3	0.001	7.21	5.9-8.6	Increase
8^th Francisco Beltrão	84.9	83.2	84.0	86.8	87.4	89.1	91.6	1.69	1.3-2.1	<0.001	4.52	3.9-5.2	Increase
9^th Foz do Iguaçu	85.6	85.4	87.1	89.0	89.4	90.8	92.5	1.29	1.1-1.5	<0.001	3.41	3.1-3.7	Increase
10^th Cascavel	87.7	86.9	87.9	90.2	89.5	89.7	93.3	0.88	0.4-1.3	0.005	2.30	1.6-3.0	Increase
11^th Campo Mourão	82.2	80.6	81.9	86.5	86.4	88.5	90.6	1.91	1.4-2.4	<0.001	5.28	4.4-6.2	Increase
12^th Umuarama	84.9	84.0	85.4	90.6	90.5	91.4	92.4	1.70	0.9-2.5	0.005	4.55	3.1-6.0	Increase
13^th Cianorte	71.3	70.8	73.1	82.1	80.3	82.9	87.8	3.08	2.0-4.2	0.001	9.53	7.3-11.8	Increase
14^th Paranavaí	88.4	87.4	88.6	91.1	90.6	92.0	95.2	1.29	0.8-1.8	0.002	3.32	2.6-4.1	Increase
15^th Maringá	86.3	86.3	87.8	91.0	90.4	91.3	94.3	1.34	0.9-1.8	0.001	3.51	2.8-4.3	Increase
16^th Apucarana	76.7	75.6	76.3	83.1	84.4	86.9	90.2	2.98	2.2-3.8	<0.001	8.68	7.1-10.2	Increase
17^th Londrina	83.2	82.6	83.3	87.2	88.1	89.0	91.6	1.74	1.3-2.2	<0.001	4.73	3.9-5.5	Increase
18^th Cornélio Procópio	76.3	76.1	76.7	82.3	81.0	85.0	86.4	2.04	1.5-2.5	<0.001	5.98	5.0-6.9	Increase
19^th Jacarezinho	76.0	74.9	75.7	83.8	84.0	85.5	87.6	2.61	1.5-3.7	0.003	7.72	5.6-9.9	Increase
20^th Toledo	80.7	79.7	81.0	84.9	83.7	86.8	91.2	1.95	1.2-2.7	0.002	5.39	4.1-6.7	Increase
21^st Telêmaco Borba	78.3	78.6	79.1	79.1	80.3	80.9	83.0	1.86	0.3-3.4	0.030	5.25	2.5-8.0	Increase
22^nd Ivaiporã	75.0	73.9	73.7	81.3	84.1	87.5	90.4	3.65	2.5-4.8	0.001	10.80	8.6-13.1	Increase
City Administration of Curitiba	91.0	90.5	91.3	92.7	93.1	93.8	95.0	0.84	0.7-1.0	<0.001	2.12	1.9-2.3	Increase
Paraná	85.8	85.3	86.2	89.3	89.7	90.9	92.8	1.44	1.1-1.8	<0.001	3.79	3.3-4.3	Increase

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[1] Corresponding author: Yanna Dantas Rattmann, Public and Environment Health Laboratory, Pharmacy course, Universidade Federal do Paraná, Campus Jardim Botânico, Avenida Lothário Meissner, 632, Jardim Botânico, Zip code: 80210-170 – Curitiba, PR, Brazil. Phone: (55 41) 3360-4073, E-mail: yannadr@gmail.com