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Beyond viral suppression of HIV - the new quality of life
                frontier

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BACKGROUND: In 2016, the World Health Organization (WHO) adopted
                a new Global Health Sector Strategy on HIV for 2016-2021. It
                establishes 15 ambitious targets, including the '90-90-90'
                target calling on health systems to reduce under-diagnosis of
                HIV, treat a greater number of those diagnosed, and ensure that
                those being treated achieve viral suppression. DISCUSSION: The
                WHO strategy calls for person-centered chronic care for people
                living with HIV (PLHIV), implicitly acknowledging that viral
                suppression is not the ultimate goal of treatment. However, it
                stops short of providing an explicit target for health-related
                quality of life. It thus fails to take into account the needs of
                PLHIV who have achieved viral suppression but still must contend
                with other intense challenges such as serious non-communicable
                diseases, depression, anxiety, financial stress, and experiences
                of or apprehension about HIV-related discrimination. We propose
                adding a 'fourth 90' to the testing and treatment target: ensure
                that 90 % of people with viral load suppression have good
                health-related quality of life. The new target would expand the
                continuum-of-services paradigm beyond the existing endpoint of
                viral suppression. Good health-related quality of life for PLHIV
                entails attention to two domains: comorbidities and
                self-perceived quality of life. CONCLUSIONS: Health systems
                everywhere need to become more integrated and more
                people-centered to successfully meet the needs of virally
                suppressed PLHIV. By doing so, these systems can better meet the
                needs of all of their constituents - regardless of HIV status -
                in an era when many populations worldwide are living much longer
                with multiple comorbidities.

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Articles publicats en revistes (ISGlobal)

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Beyond viral suppression of HIV - the new quality of life
                frontier