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The challenges of ending AIDS in Asia: outcomes of the Thai National AIDS Universal Coverage Programme, 2000-2014.
Chaivooth, Suchada; Bhakeecheep, Sorakij; Ruxrungtham, Kiat; Teeraananchai, Sirinya; Kerr, Stephen J; Teeraratkul, Achara; Sirinirund, Petchsri; Ongwandee, Sumet; Avihingsanon, Anchalee; Benjarattanaporn, Patchara; Phanuphak, Nittaya; Sungkanuparph, Somnuek; Mekthon, Sophon; Phanuphak, Praphan.
Afiliação
  • Chaivooth S; HIV/AIDS, Tuberculosis and Infectious Diseases Program, National Health Security Office (NHSO), Thailand.
  • Bhakeecheep S; HIV/AIDS, Tuberculosis and Infectious Diseases Program, National Health Security Office (NHSO), Thailand.
  • Teeraananchai S; HIV-NAT, Thai Red Cross AIDS Research Centre, Bangkok, Thailand.
  • Kerr SJ; HIV-NAT, Thai Red Cross AIDS Research Centre, Bangkok, Thailand.
  • Teeraratkul A; Thailand MOPH-US CDC Collaboration, Nonthaburi, Thailand.
  • Sirinirund P; Ministry of Public Health, Nonthaburi, Thailand.
  • Ongwandee S; Ministry of Public Health, Nonthaburi, Thailand.
  • Benjarattanaporn P; Joint United Nations Programme on HIV/AIDS, Bangkok, Thailand.
  • Phanuphak N; Thai Red Cross AIDS Research Centre, Bangkok, Thailand.
  • Sungkanuparph S; Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
  • Mekthon S; Ministry of Public Health, Nonthaburi, Thailand.
J Virus Erad ; 3(4): 192-199, 2017 Oct 01.
Article em En | MEDLINE | ID: mdl-29057081
OBJECTIVES: We sought to determine Thai National AIDS Program (NAP) outcomes and gaps, and success in reaching the WHO 90:90:90 goals. METHODS: Retrospective study of treatment outcomes, mortality and loss to follow-up (LTFU), of all individuals aged >15 years who registered to the NAP from 2000 to 2014. We focused outcomes on data from 2008 when the NAP was linked to the death registry. RESULTS: A total of 429,294 patients registered to the NAP up to November 2014, and 309,313 patients aged >15 years started ART. Median (IQR) age was 37 (31-43) years; 51% were male. From 2008 to 2014, long-term follow-up rates per 100 person-years were 3.2 in those who started ART vs 3.5 in those who did not (P<0.001) and mortality rates per 100 person-years were 3.5 in those who started ART vs 4.9 in those who did not (P<0.001). Mortality reduced from 16% in 2008 to 3% in 2014 for those who started ART. For patients starting treatment since 2000, 87% of those alive and with a recent viral load (VL) result had <50 copies/mL, and 6% had VL ≥1000 copies/mL. In a continuum-of-care analysis from 2008 to 2014, 68% were living and retained on ART, and 46% of diagnosed individuals were virally suppressed at <50 copies/mL. CONCLUSIONS: In the Thai NAP, death and LTFU are major factors disrupting the care-continuum, and many patients initiate ART with low CD4 cell counts. Rolling out systems for early detection and treatment for all, regardless of CD4 cell count, are essential and under way.
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Texto completo: 1 Base de dados: MEDLINE Tipo de estudo: Observational_studies / Screening_studies Idioma: En Ano de publicação: 2017 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Tipo de estudo: Observational_studies / Screening_studies Idioma: En Ano de publicação: 2017 Tipo de documento: Article