P2. Care and Antiretroviral Treatment in the Complete Swedish HIV-infected Cohort

Magnus Gisslén1, Veronica Svedhem Johansson2, Lena Lindborg3, Leo Flamholc4, Eva-Lena Fredriksson2, Hans Norrgren5, Suzanne Wendahl6, Anders Sönnerborg2

Affiliates: 1Department of Infectious Diseases, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden, 2Department of Infectious Diseases Karolinska University Hospital, Stockholm, Sweden, 3Department of Infectious Diseases/Venhälsan, South General Hospital, Stockholm, Sweden, 4Department of Infectious Diseases, Skåne University Hospital Malmö, Sweden, 5Department of Clinical Sciences Lund, Lund University, Lund, Sweden, 6Department of Infectious Diseases, Sunderby Hospital, Luleå, Sweden

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Background
Access to antiretroviral treatment (ART) has dramatically reduced HIV-related mortality and morbidity, but for viral suppression and good clinical outcome, HIV-infected individuals must fulfill several steps along the HIV care continuum.
It has been estimated that only 28% of HIV-infected individuals in the United States have suppressed HIV- 1 RNA levels. The process of achieving virologic suppression proceeds through 5 stages: HIV diagnosis, linkage to care, retention in care, receipt of ART, and virologic suppression. This progression is often called the cascade of care or the HIV care continuum.

Methods
All patients in Sweden diagnosed with HIV are included in the InfCare HIV database. We used InfCare HIV data reported through May 2015 to estimate the HIV care continuum for the complete Swedish HIV-infected adult cohort. All adult patients ever diagnosed with HIV and still alive were included.

Results
Using HIV surveillance data reported to the Public Health Agency of Sweden it was estimated that 10% of all HIV-infected subjects in Sweden remain undiagnosed. Among 6794 diagnosed patients, >99.9% were linked to care and >99% of those stayed in care. 94.3% were on ART and of those 95.5% had a viral load <50 copies/mL (snapshot analysis). The vast majority of patients with a viral load >50 copies/mL had a so called viral blip and a subsequent viral load <50 copies/mL.

Conclusions
Of estimated 8000 HIV-infected subjects in Sweden, 90% were diagnosed with HIV, and 80% were on suppressive ART with a viral load <50 copies/mL.

Access to antiretroviral treatment (ART) has dramatically reduced HIV-related mortality and morbidity, but for viral suppression and good clinical outcome, HIV-infected individuals must fulfill several steps along the HIV care continuum.

It has been estimated that only 28% of HIV-infected individuals in the United States have suppressed HIV- 1 RNA levels. The process of achieving virologic suppression proceeds through 5 stages: HIV diagnosis, linkage to care, retention in care, receipt of ART, and virologic suppression. This progression is often called the cascade of care or the HIV care continuum.