Desafios e perspectivas no tratamento do HIV: análise do perfil clínico e epidemiológico de pacientes em abandono de tratamento antirretroviral em Santa Maria/RS

Abstract

The infection by HIV is still a public health problem that affects populations all over the world. Although we have advanced in the fight against the virus, it is not yet possible to completely eradicate it. In this sense, prevention actions and research on the treatment and overall situation of people living with HIV are fundamental to ensure a future without the disease. Understanding the reality of the epidemic in our social context and finding effective ways to prevent and treat the disease becomes of extreme importance, as this contributes to reducing the stigma and discrimination faced by people living with HIV. The present study aimed to evaluate the profile of patients who have abandoned antiretroviral treatment linked to UDM / SAE Casa Treze de Maio, and the profile of patients who were hospitalized at the Santa Maria University Hospital due to abandonment of antiretroviral treatment, advanced stage diagnosis of HIV / AIDS, and/or poor adherence to treatment, as well as their relationships. We used methods such as collecting data in the Logistical Control System of Medicines, in the Laboratory Examination Control System, and in the clinical records of the two services under study, applying filters, and using data analysis software. The profiles were evaluated based on gender, age, and education as main parameters, and in an associative way, the use of the public and private system, the time of abandonment of treatment and recidivism of abandonment, the antiretroviral regimens used, the number of CD4+ T lymphocytes (CD4+ T cells) and viral load, co-infections, and finally, the clinical outcome of hospitalizations and post-hospitalizations were evaluated. The results showed that among the individuals who abandoned antiretroviral treatment (n=114), there was a predominance of males aged 20 to 39, low level of education, undetectable viral load, relatively high CD4+ T cell count, and the vast majority abandoned treatment within less than one year of its initiation. On the other hand, among the individuals with HIV who were hospitalized (n=33), a higher percentage of women were observed, aged between 30 and 49, low level of education, hospitalization due to late diagnosis of HIV/AIDS, with CD4+ T cell count below 50 cells/mm3 and average viral load of 600,944 copies/mL of blood, where death was one of the outcomes found. It is concluded that actions are needed that not only prevent patients from abandoning treatment, but also lead people living with HIV to treatment initiation more quickly, reducing hospitalizations and preventable deaths.