Epidemiology and Infectious Diseases » Human immunodeficiency virus and death

Human immunodeficiency virus and death

DOI: https://dx.doi.org/10.18565/epidem.2023.13.3.7-12

Pokrovsky V.V.
Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Moscow, Russia

The human immunodeficiency virus (HIV) pandemic, which has claimed more than 40 million lives, continues, although the use of antiretroviral therapy (ART) as the main tool in the fight against HIV is constantly expanding. Despite a significant increase in the proportion of people living with HIV (PLHIV) receiving ART, the number of new HIV infections and premature deaths of PLHIV is reducing not rapidly. This is primarily attributed to insufficient funding, but there are accumulated data indicating that strategy for the fight against HIV based on ART alone is effective enough to eliminate HIV. In Russia, despite the fact that 0.8% of the population lives with a diagnosis of HIV infection, about 60,000 new PLHIV are detected annually, more than 30,000 deaths of HIV-positive citizens are recorded, and the economic damage caused by HIV is increasing, there is a tendency to deny the epidemic the HIV spread, exaggerate the effectiveness of mass screening of the population for HIV infection and the results of mass use of ART. This leads to the fact that other HIV control measures are rarely used, and the level of knowledge of the population about HIV infection remains low and does not increase. An analysis of the available data shows that mass screening for HIV antibodies does not yet lead to a decrease in the number of detected cases of HIV infection in Russia, since it does not affect vulnerable groups of the population. An insufficiently large part of Russian PLHIV is covered by effective ART, since many of the PLHIV found during testing do not register in dispensaries, are lost from follow-up, or stop ART, and not all PLHIV receiving ART become non-contagious. Therefore, the antiepidemic effect of ART on the circulation of HIV in Russia is not yet sufficiently pronounced, but drug-resistant strains are already being transmitted. Although the number of PLHIV who die from diseases traditionally associated with HIV infection is reducing, the number of PLHIV who allegedly die from other causes is increasing. However, their premature death in most cases is also associated with HIV infection, and lethal outcomes can be observed against the background of effective ART. Further efforts to reduce the incidence of HIV infection and mortality among PLHIV should be aimed at expanding the range of preventive measures for both HIV infection and concomitant diseases and improving the quality of medical care for PLHIV.

Keywords: comorbidities, antiretroviral therapy, human immunodeficiency virus, morbidity, mortality

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About the Autors

Professor Vadim V. Pokrovsky, Academician of the Russian Academy of Sciences, MD, Head, Specialized Research Department of Epidemiology and Prevention of AIDS, Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Moscow, Russia; pokrovsky.vad@yandex.ru; https://orcid.org/0000-0002-9514-7288; Scopus Author ID: 7202457043

Human immunodeficiency virus and death

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About the Autors

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