Título:
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Beyond viral suppression of HIV - the new quality of life
frontier
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Autor/a:
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Lazarus, Jeffrey V.; Safreed-Harmon, Kelly; Barton, Simon E.; Costagliola, Dominique; Dedes, Nikos; Amo Valero, Julia del; Gatell, José M.; Baptista-Leite, Ricardo; Mendao, Luis; Porter, Kholoud; Vella, Stefano; Rockstroh, Jürgen Kurt
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Notas:
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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. |
Materia(s):
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-Sida -VIH (Virus) -AIDS (Disease) -HIV (Viruses) |
Derechos:
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cc by (c) Lazarus et al., 2016
http://creativecommons.org/licenses/by/3.0/es/
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Tipo de documento:
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Artículo Artículo - Versión publicada |
Editor:
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BioMed Central
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