ORIGINAL RESEARCH article
Front. Public Health
Sec. Infectious Diseases: Epidemiology and Prevention
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1580633
This article is part of the Research TopicTowards Control of the HIV epidemic: Trends in Epidemiology and Emerging Drug Resistance in the Integrase Inhibitor EraView all 5 articles
The use of Lorenz Curves and Gini index for the evaluation of HIV viral load distribution in an Italian community
Provisionally accepted
Stefania Arsuffi1
Martina Salvi1
Stefano Calza2Fabio Riccardo Colombo2Maria Alberti1Benedetta Fioretti1
Giorgio Tiecco1
Emanuele Focà1*
Eugenia Quiros-Roldan1- 1Division of Infectious Diseases, ASST Spedali Civili of Brescia and University of Brescia, Brescia, Lombardy, Italy
- 2Unit of Biostatistics and Bioinformatics, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
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Background Community viral load is defined as an aggregate measure of individual viral loads of people living with HIV in care in a specific community and represents an instrument to evaluate therapy program effectiveness. Our study aimed to analyze the overtime trend and the distribution characteristics of viral load. Methods Using Lorenz curves, we investigated the demographic characteristics of individuals who held the top 10% of viral loads over the years. We applied the Gini index to measure the inequality of the distribution of viral load among the study population. Results Our data showed a progressive decrease in the community viral load over the years, with a sharp decline after 2012 and a rebound in 2020. The Gini index had a specular trend during the period. In all the observed periods, the top 10% of viral loads showed a progressive increase of female individuals and in non-Italian nationals. Discussion Our study evidenced the effectiveness and the improvement of the HIV care cascade over the years, with a decrease in community HIV viral load. The introduction of integrase inhibitors seemed to have produced a rapid drop in the community viral load in 2012, but with a notable discrepancy in the homogeneity in the population. It is important to underline also the evolution in the population with the top 10% of viral loads over time, with a gradual but stable increase of female and non-Italian subjects.
Keywords: S. Arsuffi1, M. Salvi1, S. Calza2, F. R. Colombo2, M. Alberti1, B. Fioretti1, G. Tiecco1, E. Focà1*
Received: 20 Feb 2025; Accepted: 26 Jun 2025.
Copyright: © 2025 Arsuffi, Salvi, Calza, Colombo, Alberti, Fioretti, Tiecco, Focà and Quiros-Roldan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Emanuele Focà, Division of Infectious Diseases, ASST Spedali Civili of Brescia and University of Brescia, Brescia, Lombardy, Italy
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