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CDC: 30% of people with HIV achieved viral suppression
Of the approximately 1.2 million Americans with HIV, just 30% achieved viral suppression in 2011, according to November’s Vital Signs report in MMWR.
Data from the new study also indicate that among the individuals who have not successfully controlled the virus, 66% were diagnosed but not engaged in regular care. Another 20% did not yet know they were infected.
“There is untapped potential to drive down the epidemic through improved testing and treatment, but we’re missing too many opportunities,” Jonathan Mermin, MD, director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and Tuberculosis Prevention, said in a press release. “Treatment is crucial. It is one of our most important strategies for stopping new HIV infections.”
Researchers used data from the National HIV Surveillance System and the Medical Monitoring Project to estimate rates of HIV diagnosis, care and treatment. They also found that 4% of patients with HIV were engaged in care, but were not prescribed ART, and that 10% were prescribed ART but did not achieve viral suppression.
Viral suppression rates increased with age; only 13% of people aged 18 to 24 years achieved viral suppression. In contrast, 23% of people aged 25 to 34 years, 27% of people aged 35 to 44 years, 34% of people aged 45 to 54 years, 36% of people aged 55 to 64 years and 37% of people aged 65 years and older achieved viral suppression. In addition, 49% of people aged 18 to 24 years with HIV have been diagnosed.
“It’s alarming that fewer than half of HIV-positive young adults know they are infected,” Eugene McCray, MD, director of CDC’s Division of HIV/AIDS Prevention, said in the press release. “Closing that gap could have a huge impact on controlling HIV — knowing your status is the first critical step toward taking care of your own health and avoiding transmission to others.”
The study data did not suggest any differences in viral suppression by race or ethnicity, sex or risk group.
As part of the National HIV/AIDS Strategy launched in 2010, the CDC has several initiatives to promote HIV testing and treatment, including partnerships to make HIV testing more simple and accessible; programs to help health departments follow up on patients who have fallen out of care; and public awareness campaigns to urge testing and encourage people with HIV to seek ongoing care.
Thomas Frieden
“For people living with HIV, it’s not just about knowing you’re infected — it’s also about going to the doctor for medical care,” CDC Director Thomas R. Frieden, MD, MPH, said in the press release. “For health care facilities, it’s not just about the patients in your care — it’s every person diagnosed, and every person whose diagnosis has not yet been made. The key to controlling the nation’s HIV epidemic is helping people with HIV get connected to — and stay in — care and treatment, to suppress the virus, live longer and help protect others.”
Disclosure: The researchers report no relevant financial disclosures. Frieden, McCray and Mermin have no relevant financial disclosures.
Perspective
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Although our treatments for HIV infection are now potent, convenient and nontoxic, there is still much to do to realize their full potential. The recent CDC data are truly sobering. Many HIV-infected people remain undiagnosed, and many more fall through the system in many ways, not being treated or not succeeding in viral suppression. This is obviously a crucial area for further research and investment. We have to do much better.