title: The HIV care cascade in Switzerland: reaching the UNAIDS/WHO targets for patients diagnosed with HIV.
abstract: OBJECTIVE
  To describe the HIV care cascade for Switzerland in the year 2012.
  
  
  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. 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) viral loads. 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 viral load, meeting recent UNAIDS/WHO targets.
authors.affiliation: aDivision of Infectious Diseases and Infection Control, Cantonal Hospital St. Gallen bDivision of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich cCommunicable Diseases Division, Federal Office of Public Health (FOPH), Bern, Switzerland dDepartment of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, UK eDivision of Infectious Diseases and Hospital Epidemiology, University Hospital Lausanne fUniversity Clinic of Infectious Diseases, University Hospital Bern gHIV Unit, Geneva University Hospital, Geneva hDivision of Infectious Diseases and Hospital Epidemiology, University Hospital Basel iOspedale Regionale, Lugano, Switzerland.
authors.forename: Philipp
authors.initials: P
authors.lastname: Kohler
authors.forename: Axel J
authors.initials: AJ
authors.lastname: Schmidt
authors.forename: Matthias
authors.initials: M
authors.lastname: Cavassini
authors.forename: Hansjakob
authors.initials: H
authors.lastname: Furrer
authors.forename: Alexandra
authors.initials: A
authors.lastname: Calmy
authors.forename: Manuel
authors.initials: M
authors.lastname: Battegay
authors.forename: Enos
authors.initials: E
authors.lastname: Bernasconi
authors.forename: Bruno
authors.initials: B
authors.lastname: Ledergerber
authors.forename: Pietro
authors.initials: P
authors.lastname: Vernazza
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D003695:Delivery of Health Care / Q000458:organization & administration*; D004363:Drug Utilization; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D006302:Health Services Research; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D013557:Switzerland / Q000453:epidemiology; D016896:Treatment Outcome; D019562:Viral Load; D055815:Young Adult
chemical_list: D044966:Anti-Retroviral Agents