Epidemiología del VIH en Venezuela desde 1983 a 2016 / Epidemiology of HIV Infection in Venezuela since the year 1983 to the year 2016
Med. interna (Caracas)
; 35(2): 79-93, 2019. tab, graf
Article
in Es
| LIVECS, LILACS
| ID: biblio-1050494
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VE1.1
RESUMEN
Hay en el mundo, grandes avances en la lucha contra el Virus de Inmunodeficiencia Humana (VIH). En Venezuela el primer paciente con SIDA fue evaluado por el Dr. Manuel GuzmaÌn en el anÌo 1983, estimaÌndose para el anÌo 2016 120.000 personas infectadas Objetivo:
describir los indicadores epidemioloÌgicos del VIH en Venezuela desde el anÌo 1983 hasta el anÌo 2016. MetodologiÌa se revisaron documentos del Programa Nacional de VIH/SIDA/ITS del MPPS (PNS), ONUSIDA, OPS, OMS y otros documentos cientiÌficos. TambieÌn los datos epidemioloÌgicos, y el acceso a la carga viral (CV) de VIH, CD4, test de resistencia y tratamiento antirretroviral (TARV).Resultados:
Venezuela enfrenta una epidemia con- centrada, con prevalencia mayor de 5% en grupos vulnerables como los HSH y se desconoce la preva- lencia en otros grupos vulnerables. La prevalencia del VIH en los indiÌgenas waraos es de 9.5 %, una de las maÌs altas de AmeÌrica Latina, cuya situacioÌn ha sido catalogada como dramaÌtica. El nuÌmero de mujeres infectadas va en ascenso, la mayoriÌa son amas de casa con, instruccioÌn de educacioÌn prima- ria y transmisioÌn principalmente sexual. No hay datos de prevalencia de VIH de las embarazadas a nivel nacional y la tasa de transmisioÌn vertical esti- mada para el 2013 fue de 21.8 %. La tasa de mor- talidad general por VIH/SIDA para el anÌo 2015 fue de 8.3 por 100.000 habitantes, un aumento de 94 % con respecto a 1996 (4,14 x 100.000 habitantes). La tasa promedio de mortalidad por VIH/SIDA en ninÌos < de 5 anÌos, es mayor en los menores de un anÌo, con una tasa de 3,46 por 1.000 recieÌn nacidos vivos. El iÌndice de mortalidad en los hombres aumentoÌ 1.8 veces y en la mujer 3.9. El acceso a las pruebas diagnoÌsticas, CV de VIH, lin-focitos CD4 y test de resistencia estaÌ seriamente limitado. Para el anÌo 2016, de 120 mil personas con VIH , 59% teniÌa acceso al TARV y solo 7 % teniÌan supresioÌn viral. Venezuela es el paiÌs de AmeÌrica Latina, que ha experimentado maÌs interrupciones del TARV, agravaÌndose dicha situacioÌn durante 2017 y 2018, con un acceso a tratamiento de 16 %en abril de 2018, y desde esa fecha, 58.000 pacien-tes estaban en falta absoluta de TARV. Gracias al Plan Maestro, el acceso a TARV fue reiniciado en febrero del 2019. ConclusioÌn despueÌs de 30 anÌos de la epidemia del VIH en Venezuela, las poliÌticas sanitarias no han sido suficientes para detener el avance de la enfermedad, lo que evidencia el fraca-so del PNS. Es urgente y prioritario, cumplir las recomendaciones del Plan Maestro, asiÌ como otras expuestas en el presente documento(AU)ABSTRACT
Immunodeficiency Virus (HIV). The first patient with AIDS in Venezuela, was evaluated by Dr. Manuel Guzmán in 1983 and in the year 2016 the number of infected people was estimated in 120,000. Objective:
to describe the epidemiological indicators of HIV in Venezuela from 1983 to 2016. Methodology, the reviewed documents were National HIV / AIDS / STI Program of the Ministry of Popular Power for Health (PNS), UNAIDS/ WHO/PAHO Master Plan for fortifying the response to HIV, tuberculosis and malaria in our country from a public health perspective (Master Plan), and other scientific publications. Epidemiological data were reviewed as well as the access to viral load (VL) of HIV, CD4, resistance test, and antiretroviral treatment (ART).Results:
Venezuela faces a concentrated epidemic, with a prevalence of more than 5% in vulnerable groups and the prevalence in other groups is unknown. The prevalence of HIV in the Waraos Indigenous people is 9.5%, one of the highest in Latin America, the situation has been named as dramatic. Infected women are on the rise, with the majority being housewives, with elementary schooling and, mainly by sexual transmission. There are no HIV prevalence data of pregnant women nationwide and the estimated vertical transmission rate for 2013 was 21.8%. The overall mortality rate for HIV / AIDS for the year 2015 was 8.3 per 100.000 inhabitants, an increase of 94% compared to 1996 (4.14 x 105). The mortality index in men increased 1.8 times and in women 3.9. The average mortality rate for HIV / AIDS in children under 5 years of age is higher in those under one year of age, with a rate of 3.46 per 1000 live births. In 2014, maternal deaths due to AIDS represented 2.5%, there are no updated data. Access to diagnostic tests, VL, lymphocyte CD4 and resistance test is severely limited. For the year 2016, 120.000 persons were living with HIV in Venezuela, 59% had access to ART, but only 7% had suppression of LV. Venezuela is the country in Latin America, which has experienced more interruptions of ART. Aggravating this situation during 2017 and 2018, with an access to treatment of 16 % in April 2018. Since then, approximately 58,000 patients receive no ART at all. Thanks to the Master Plan access to ART was reinitiated in February 2019.Conclusions:
more than 30 years after the HIV epidemic in Venezuela, health policies have been sufficient to stop the progression of the disease, which shows the failure of the National HIV /AIDS / STI Program. It is a priority to comply with the recommendations of the Master Plan, as well as others set out in this document(AU)Key words
Full text:
1
Index:
LILACS
Main subject:
Communicable Diseases
/
Acquired Immunodeficiency Syndrome
/
HIV
/
Anti-Retroviral Agents
Type of study:
Guideline
/
Risk_factors_studies
/
Screening_studies
Limits:
Female
/
Humans
/
Male
Country/Region as subject:
America do sul
/
Venezuela
Language:
Es
Journal:
Med. interna (Caracas)
Journal subject:
Glndulas End¢crinas
/
Hormnios
/
MEDICINA INTERNA
Year:
2019
Type:
Article