Santé Publique France presented the 2021 figures for HIV discoveries in France at the 2022 SFLS congress. They are not as good as one would have hoped.
The long-awaited shift in the number of new contaminations, which began in 2020, does not seem to be confirmed for the year 2021. According to figures from Public Health France, presented at the SFLS congress by Florence Lot, the number of discoveries of seropositivity is estimated at 5013 people, once morest 4753 in 2020. A figure that can be considered as stable, the confidence intervals overlapping. Not really something to celebrate, while the prevention tools have never been so effective.
This trend is confirmed by the stability of the number of antiretroviral treatment initiations (now quickly following diagnosis), taken from data from the National Health Data System (SNDS).
These diagnostic figures have been stable for all affected populations since last year, but the trend has been for a slight increase since 2012 among men who have sex with men (MSM Man having sex with other men. ) foreign born and trans people.
Early and late screening figures are also stable, although a slight trend towards less precocity seems to be emerging among MSM. Overall, there is no improvement in early diagnosis.
A screening recourse which still does not increase sufficiently
These are 5.7 million serologies HIV Human immunodeficiency virus. In English: HIV (Human Immunodeficiency Virus). Isolated in 1983 at the Pasteur Institute in Paris; recently discovered (2008) rewarded with the Nobel Prize in Medicine awarded to Luc Montagnier and Françoise Barré-Sinoussi. which were carried out in 2021, an increase of 8% compared to 2020. But this number had fallen by 13% in 2020 compared to 2019. We therefore do not quite find the pre-covid A coronavirus disease, sometimes called covid (following the English acronym of coronavirus disease) is a disease caused by a coronavirus (CoV). The term may refer to the following illnesses: Severe Acute Respiratory Syndrome (SARS) caused by the SARS-CoV virus, Middle East Respiratory Syndrome (MERS) caused by the MERS-CoV virus, Coronavirus disease 2019 ( Covid-19) caused by the SARS-CoV-2 virus. in terms of the total number of serologies performed in 2021.
A possible use of self-tests does not allow this figure to be put into perspective, since following a 30% drop between 2019 and 2020, the number of self-tests sold in pharmacies has only increased once more by 15%.
On the other hand, the good screening figures for the first half of the year seem to show an improving trend, with almost 2,500,000 having benefited from at least one HIV screening at the start of the year. The highest level since 2014.
In CHEGIDD Free Center for Information, Screening and Diagnosis (CeGIDD) for human immunodeficiency virus infections, viral hepatitis and sexually transmitted infections. These centers have replaced the Anonymous and Free Testing Centers (CDAG) since 1 January 2016.following a drop in the number of screenings of 35% in 2020 – the centers were closed because of the confinements – the number of serologies carried out increased by 16%, there too, at an insufficient level.
Data too fragile
It must be said frankly: the HIV epidemic in France is a poorly monitored epidemic and it is the whole quality of epidemiological information that has deteriorated in recent years, because we lack raw data. Despite the still remarkable work of epidemiologists from Public Health France, the data for 2021, although illuminating, therefore remain fragile. And this lack of robust data prevents teams from producing reliable incidence data (of the time of infection, therefore, and not only of the time of discovery of the infection).
Remember that HIV is a notifiable infection, but last year, only 59% of mandatory declarations were completed by biologists and clinicians. Completeness is therefore once once more down compared to the previous year, with only 2,917 reports received by Public Health France. It is this number that has been corrected, taking into account delays, under-reporting and missing values, to obtain the figure of 5013 new discoveries of HIV in 2020.
For Olivier Bouchaud, co-president of the SFLS congress with Bernadette Rwegera, the first avenues to explore to improve this situation are the implementation of an easier SNDS query and the integration of HIV into the infection reporting system. SIDEP SIDEP (Population DEpistage Information System) is a monitoring system which aims to comprehensively monitor all the tests carried out in France in city laboratories and in hospital laboratories for the search for SARS-CoV-2.. He also pleads for CoreVIH, as part of their outreach work, to obtain the means to carry out and maintain quality microbiology.
