(Adnkronos) - I nuovi casi di Hiv in Campania sono stabili, il problema è però la diagnosi tardiva. Cosi Vincenzo Esposito presidente SIMIT Campania a margine del Congresso “ Le malattie infettive nel setting del paziente immunodepresso” in corso a Napoli e durante il quale si è parlato dell’efficacia della terapia Long Acting nella cura e nei vantaggi significativi per la qualità di vita dei pazienti.
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00:00How do you judge as a scientific society the experience of long-acting therapy and do patients benefit from it?
00:13Frankly, yes, it is a positive experience that all the centers in Italy and also in Europe and in the world are having.
00:20It is an experience of a paradigm shift because we go from a therapy that is administered to the patient directly to the structure on which it is performed.
00:29This has two advantages.
00:30On the one hand, it is equally effective compared to other antiretroviral regimens.
00:34On the other hand, we also have the result of obtaining excellent adherence to the patient's therapy,
00:38which, being administered in-site, is obviously observed directly by the operator.
00:43On the other hand, one of the important issues in HEV is that of adherence to therapy.
00:47If a patient does not take the therapy in a precise way, it risks generating resistance in the virus
00:53and then having complications for future treatments and also risks transmitting the infection.
00:58Therefore, improving adherence is a fundamental thing in our field,
01:02as well as the de-stigmatizing aspect of a therapy that is not brought home.
01:07The patient does not have to bring the boxes with him, but he has to take them at certain times.
01:11It is very important.
01:12This has also been emphasized by both patient associations and by the patients themselves,
01:16who often make requests for this regimen,
01:18and the request is considered in relation to the type of patient,
01:21because obviously each therapy is based on what the patient is and on his clinical history,
01:27his expectations and prospects.
01:29At what point are we on the path of ambulatory therapy?
01:34We started a little late, but at the moment we are at a good point,
01:37in the sense that the paradigm shift was not only for the patient,
01:41but it was above all for the structures that must carry out this service,
01:44by opening dedicated ambulatories.
01:47This has meant a joint effort by both doctors and politicians
01:52to create a path that goes in this direction.
01:55The Campania Region has asked all prescription centers to equip themselves with these ambulatories.
01:59Lists of doctors who take care of these patients have been identified,
02:04and on this basis they must obtain the ability to access the platforms
02:08for the direct prescription of these drugs,
02:10as well as all those that are the instrumental clinical investigations of the regional PDTA,
02:15because there is a very strict regulation on the privacy of these patients,
02:19so an ambulatory prescription cannot pass through third parties,
02:23but must be issued by the same doctor who follows the patient.
02:27This has meant that the system has been slightly revolutionized,
02:30and now it is sending the path that must then be activated in all clinics,
02:37which at the moment are being set up in an extemporaneous way
02:40to solve the problem while waiting for us to have the definitive path.
02:44The data are not worrying because they are not increasing,
02:47but they are not even decreasing.
02:49Let's say that we have more or less always the same number of patients,
02:52obviously the number is increasing because these patients,
02:54thank God, now have a survival rate comparable to that of the general population,
02:58but the new infections are more or less the same every year.
03:02The problem is that we are having many more advanced infections,
03:05that is, we diagnose HIV disease,
03:10unfortunately, very late.
03:14So the message I want to send is to stimulate screening.
03:18There is the possibility of being tested anonymously in many centers in Campania,
03:22practically every day, without a prescription,
03:25so anyone can do it, and it is good that I do it,
03:28because this is a disease that, if diagnosed in time,
03:31does not create major problems with another pathology.
03:35HIV has become a chronic condition if diagnosed in time.
03:39If diagnosed in time, it can lead to fatal consequences.
03:43What are the most at-risk patients?
03:46Can you give us a picture of who is the patient who is HIV-positive today?
03:52There is no longer a category of at-risk patients,
03:55as was once said by drug addicts or sex workers.
03:58Whoever is at risk, the most frequent transmission is due to heterosexuality,
04:02so you can't trace the identikit.
04:05This is also a somewhat stigmatizing concept of the past,
04:08which we have overcome.
04:10We are now talking about people who live with HIV,
04:13we are not even talking about patients,
04:15because a condition, more than a disease,
04:17I insist, if it is diagnosed, it is treated in time.
04:20A patient, a person who contracted the disease,
04:23if it is treated, does not transmit the disease.
04:26This is the message we have to send,
04:28rather than identifying.
04:30Prevention is not done by choosing the categories at risk.
04:33There are no categories at risk.
04:35There are few, because the number of tests we do are few,
04:38fortunately for people who are HIV-positive.