Abstract

The viral load test as a predictor of quality of care of patients receiving treatment antirretoviral in Mexico

C. Magis-Rodriguez, J.A. Izazola-Licea, E. Bravo-Garcia

Centro Nacional para la Prevención y el Control del VIH/SIDA - CENSIDA, Mexico, Mexico

Background: At 31 December 2009, a total of 32.468 patients were receiving antiretroviral treatment for HIV/AIDS in the units of the Ministry of Health throughout the country. The World Health Organization recommends increasing the use of laboratory tests (viral load and CD4) to improve the quality of care received by people with HIV.
Methods: The viral load and CD4 tests of patients receiving antiretroviral therapy were analyzed (database SALVAR system). Patients were classified into two groups: "undetectable viral load" (< 400 copies/ml) and "detectable viral load" (>=400 copies/ml); and in three categories according to the number of tests in the last twelve months (1, 2 or 3 and more). Patients without informacion were excluded.
Results: The 62.6% (20.328) of patients have undetectable viral load, 19.8% (6.434) and detectable viral load by 17.6% have no information. Comparing both groups, patients with undetectable viral load have significantly greater number of viral load tests, compared with patients with detectable viral load (p < .0001). The previous exercise was conducted for the CD4 cell count, and obtained similar results: patients with undetectable viral load have significantly more CD4 test, compared with patients with detectable viral load (p < .0001 ).
Conclusions: The results indicate that Mexico needs to provide universal access to viral load testing and CD4 (at least 3 per year). To the extent this is achieved, proportion of patients with undetectable viral load will be greater, and will have a significant impact on survival of patients and in reducing mortality due to AIDS. Additionally, another studies have shown that patients with less monitoring developed greater resistance and therapeutic failure.