- By the end of 2022, 39 million people infected with HIV were counted around the planet.
- Within the new recommendations for HIV detection, the WHO requests governments to disseminate the tests through social networks.
- If the infection is diagnosed and treated in a timely manner and the patient takes the medication as prescribed, his life expectancy and health will be the same as that of an uninfected person.
Today the World Health Organization (WHO) presented New scientific data and policy guidance on HIV and its correct detection. It all happened within the framework of the 12th edition of the International AIDS Society Conference on Science and HIV (IAS 2023).
With this in mind, new WHO guidelines were released, as well as a systematic review in The Lancet on the role of HIV suppression and undetectable levels of this virus to improve the health of those infected and stop the transmission of the virus to others.
Viral load thresholds and approaches to classify virus concentrations based on these thresholds are mentioned in the guidance. For example, it is explained that people whose HIV levels are undetectable thanks to regular antiretroviral treatment do not transmit the virus to their sexual partners and that the risk of transmitting it vertically to their children is low.
In addition, scientific data indicates that when a person is HIV-suppressed (ie, when their viral load is 1,000 copies per milliliter or less), the risk of transmitting the virus is negligible or almost zero.
Antiretroviral treatments continue to improve the lives of people living with HIV. If the infection is diagnosed and treated early and the patient takes the medication as prescribed, his life expectancy and health will be the same as an uninfected person.
By the end of 2022, there were 39 million people with HIV infection in the world. Of these, 29.8 million (76%) were on antiretroviral therapy and almost three-quarters (71%) had achieved viral suppression, meaning their health is not affected and they are not at risk of transmitting HIV to others. However, although progress is noticeable in adults, only 46% of children with HIV are virally suppressed.
New for HIV detection
In their new recommendations on testing for HIV infectionWHO calls on countries to expand the use of self-testing and to promote screening through sexual and social networks to increase coverage and increase the use of infection prevention and treatment services in the most affected places and in the regions with the greatest gaps in test coverage.
These recommendations come at a time when self-testing and self-care are increasingly being confirmed as ways to increase access, efficiency, effectiveness, and acceptability of health care in many settings, including HIV.
HIV and monkeypox
The WHO received the data from a global surveillance analysis conducted during the monkeypox outbreak that affected several countries. In this analysis, more than 82,000 cases of monkeypox were collected, of which 32,000 had associated information on HIV serological status.
Of the 32,000 individuals, 52% were living with HIV. Most of them were men who had sex with men, and more than 80% stated that the most likely way they had contracted monkeypox was sexually.
Of the 16,000 HIV-positive people diagnosed with monkeypox, 25% had advanced symptoms of infection or immunosuppression, putting them at increased risk of hospitalization and death.
On the other hand, it was observed that, in people with HIV who were being treated for this infection and who had a good immune response, the rates of hospitalization and death were comparable to those of seronegative people for this virus.
Taking these data into account, WHO recommends that countries integrate detection, prevention and treatment of monkeypox into existing and new programs for the prevention and control of HIV infection and sexually transmitted infections.
To better understand how to prepare for and respond to possible increases in monkeypox transmission in the future, WHO organized a rapid online survey in May 2023, restricted to the European and American regions, to learn about experiences gained at the community level during the monkeypox outbreak in 2022 and 2023.
This survey was sent to 24,000 men who have sex with men, transgender and gender diverse people. Of the 16,785 eligible individuals who responded to the survey, almost 51% reported that they had changed their sexual behavior (for example, they had reduced the number of sexual partners) and 35% that they maintained those behavior changes one year later.
The results of this survey provide valuable information on the experiences and needs of groups affected by monkeypox and highlight the importance of promoting vaccination and diagnosis of this disease throughout the world.
HIV and COVID-19
In a new analysis published by the WHO in its global clinical platform on COVID-19 In May 2023, it was found that people with HIV hospitalized for COVID-19 during the waves caused by the pre-delta variants, the delta variant and the omicron variant were persistently at greater risk of dying, as demonstrated by the overall mortality rate of between 20% and 24% among these hospitalized individuals.
For HIV-negative individuals, the risk of death decreased by 53% to 55% during the omicron wave compared with the pre-delta and delta wave; however, in seropositives, the percentage decrease in mortality during the period that the wave of the omicron variant lasted with respect to the other waves was modest (between 16% and 19%).
This difference translated into a 142 times higher risk of death among people living with HIV compared to seronegatives during the period of the wave of the omicron variant.
Risk factors for death during hospitalization that were common to all waves of the pandemic were a low CD4 lymphocyte count (less than 200 cells/m3) and the presence of severe or critical symptoms of COVID-19 at the time of admission.
Also read:
The 3 main tests for the timely detection of HIV
Sexually Transmitted Infections: Main medical tests for their detection
Cofepris authorizes a new drug for the treatment of HIV