Original Article: bit.ly/1tJHXhz
Australia and northern European countries are doing far better than North America at retaining people living with HIV in care and achieving viral suppression, according to a comprehensive survey of `treatment cascades` in high-income countries presented on Tuesday at the International Congress on Drug Therapy in HIV Infection in Glasgow.
However, even in the best-performing countries viral suppression falls short of the aspirational target recently set by UNAIDS, and the survey identified country-specific weaknesses in performance. In the United Kingdom diagnosis of HIV infection is the major weakness preventing higher rates of viral suppression in the population living with HIV, whereas linkage to care emerged as the primary weakness in the United States.
Patients taking HIV therapy who have an undetectable viral load have a low risk of disease progression and onward HIV transmission. However, a large number of individuals are not benefiting from antiretroviral treatment because they are not engaged with the so-called “treatment cascade.” This has five stages, specifically diagnosis, linkage to care, retention in care, initiation of HIV therapy, adherence to therapy and achievement of an undetectable viral load.
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