Publication
The HIV care cascade in Switzerland: reaching the UNAIDS/WHO targets for patients diagnosed with HIV
Journal Paper/Review - Sep 13, 2015
Kohler Philipp, Vernazza Pietro, Ledergerber Bruno, Bernasconi Enos, Battegay Manuel, Calmy Alexandra, Furrer Hansjakob, Cavassini Matthias, Schmidt Axel J, and the Swiss HIV Cohort Study
Units
PubMed
Doi
Citation
Type
Journal
Publication Date
Issn Electronic
Brief description/objective
OBJECTIVES
To describe the HIV care cascade for Switzerland in the year 2012.
DESIGN/METHODS
Six levels were defined: (i) HIV-infected, (ii) HIV-diagnosed, (iii) linked to care, (iv) retained in care, (v) on antiretroviral treatment (ART), and (vi) with suppressed viral load (VL). We used data from the Swiss HIV Cohort Study (SHCS) complemented by a nationwide survey among SHCS physicians to estimate the number of HIV-patients not registered in the cohort. We also used Swiss ART sales data to estimate the number of patients treated outside the SHCS network. Based on the number of patients retained in care, we inferred the estimates for levels (i) to (iii) from previously published data.
RESULTS
We estimate that (i) 15,200 HIV-infected individuals lived in Switzerland in 2012 (margins of uncertainty, 13,400-19,300). Of those, (ii) 12,300 (81%) were diagnosed, (iii) 12,200 (80%) linked, and (iv) 11,900 (79%) retained in care. Broadly based on SHCS network data, (v) 10,800 (71%) patients were receiving ART, and (vi) 10,400 (68%) had suppressed (<200 copies/ml) VLs. The vast majority (95%) of patients retained in care were followed within the SHCS network, with 76% registered in the cohort.
CONCLUSIONS
Our estimate for HIV-infected individuals in Switzerland is substantially lower than previously reported, halving previous national HIV prevalence estimates to 0.2%. In Switzerland in 2012, 91% of patients in care were receiving ART, and 96% of patients on ART had suppressed VL, meeting recent UNAIDS/WHO targets.