Beyond viral suppression of HIV – the new quality of life frontier

Autor: Stefano Vella, Kelly Safreed-Harmon, Dominique Costagliola, Kholoud Porter, Julia del Amo Valero, José M. Gatell, L. Mendao, Ricardo Baptista-Leite, N. Dedes, Jürgen K. Rockstroh, S. Barton, Jeffrey V. Lazarus
Přispěvatelé: University of Barcelona, Centre for Health and Infectious Disease Research, IT University of Copenhagen (ITU), Imperial College London, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), European AIDS Treatment Group [Bruxelles], Instituto de Salud Carlos III [Madrid] (ISC), Hospital Clinic-IDIBAPS, Universidade Católica Portuguesa, Universidade Católica Portuguesa [Porto], Maastricht University [Maastricht], University College of London [London] (UCL), Istituto Superiore di Sanita [Rome], Bonn University Hospital, HAL-UPMC, Gestionnaire, IT University of Copenhagen, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Pierre et Marie Curie - Paris 6 (UPMC), Istituto Superiore di Sanità (ISS), University Hospital Bonn, Not applicable., Veritati - Repositório Institucional da Universidade Católica Portuguesa
Jazyk: angličtina
Rok vydání: 2016
Předmět:
Zdroj: BMC Medicine
BMC Medicine, BioMed Central, 2016, 14 (1), pp.94. ⟨10.1186/s12916-016-0640-4⟩
Recercat. Dipósit de la Recerca de Catalunya
instname
Lazarus, J V, Safreed-Harmon, K, Barton, S E, Costagliola, D, Dedes, N, Del Amo Valero, J, Gatell, J M, Baptista-Leite, R, Mendão, L, Porter, K, Vella, S & Rockstroh, J K 2016, ' Beyond viral suppression of HIV : the new quality of life frontier ', BMC Medicine, vol. 14, 94 . https://doi.org/10.1186/s12916-016-0640-4
BMC Medicine, 2016, 14 (1), pp.94. ⟨10.1186/s12916-016-0640-4⟩
Repisalud
Instituto de Salud Carlos III (ISCIII)
Dipòsit Digital de la UB
Universidad de Barcelona
Repositório Científico de Acesso Aberto de Portugal
Repositório Científico de Acesso Aberto de Portugal (RCAAP)
instacron:RCAAP
ISSN: 1741-7015
DOI: 10.1186/s12916-016-0640-4⟩
Popis: BACKGROUND: In 2016, the World Health Organization (WHO) adopted a new Global Health Sector Strategy on HIV for 2016-2021. It establishes 15 ambitious targets, including the '90-90-90' target calling on health systems to reduce under-diagnosis of HIV, treat a greater number of those diagnosed, and ensure that those being treated achieve viral suppression. DISCUSSION: The WHO strategy calls for person-centered chronic care for people living with HIV (PLHIV), implicitly acknowledging that viral suppression is not the ultimate goal of treatment. However, it stops short of providing an explicit target for health-related quality of life. It thus fails to take into account the needs of PLHIV who have achieved viral suppression but still must contend with other intense challenges such as serious non-communicable diseases, depression, anxiety, financial stress, and experiences of or apprehension about HIV-related discrimination. We propose adding a 'fourth 90' to the testing and treatment target: ensure that 90 % of people with viral load suppression have good health-related quality of life. The new target would expand the continuum-of-services paradigm beyond the existing endpoint of viral suppression. Good health-related quality of life for PLHIV entails attention to two domains: comorbidities and self-perceived quality of life. CONCLUSIONS: Health systems everywhere need to become more integrated and more people-centered to successfully meet the needs of virally suppressed PLHIV. By doing so, these systems can better meet the needs of all of their constituents - regardless of HIV status - in an era when many populations worldwide are living much longer with multiple comorbidities.
Databáze: OpenAIRE