| Potential impact of antiretroviral therapy on HIV-1 transmission and AIDS mortality in resource-limited settings. | |
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MedLine Citation:
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PMID: 16652038 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To estimate the potential impact of antiretroviral therapy on the heterosexual spread of HIV-1 infection and AIDS mortality in resource-limited settings. METHODS: A mathematic model of HIV-1 disease progression and transmission was used to assess epidemiologic outcomes under different scenarios of antiretroviral therapy, including implementation of World Health Organization guidelines. RESULTS: Implementing antiretroviral therapy at 5% HIV-1 prevalence and administering it to 100% of AIDS cases are predicted to decrease new HIV-1 infections and cumulative deaths from AIDS after 10 years by 11.2% (inter-quartile range [IQR]: 1.8%-21.4%) and 33.4% (IQR: 26%-42.8%), respectively. Later implementation of therapy at endemic equilibrium (40% prevalence) is predicted to be less effective, decreasing new HIV-1 infections and cumulative deaths from AIDS by 10.5% (IQR: 2.6%-19.3%) and 27.6% (IQR: 20.8%-36.8%), respectively. Therapy is predicted to benefit the infected individual and the uninfected community by decreasing transmission and AIDS deaths. The community benefit is greater than the individual benefit after 25 years of treatment and increases with the proportion of AIDS cases treated. CONCLUSIONS: Antiretroviral therapy is predicted to have individual and public health benefits that increase with time and the proportion of infected persons treated. The impact of therapy is greater when introduced earlier in an epidemic, but the benefit can be lost by residual infectivity or disease progression on treatment and by sexual disinhibition of the general population. |
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Authors:
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Ume L Abbas; Roy M Anderson; John W Mellors |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of acquired immune deficiency syndromes (1999) Volume: 41 ISSN: 1525-4135 ISO Abbreviation: J. Acquir. Immune Defic. Syndr. Publication Date: 2006 Apr |
Date Detail:
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Created Date: 2006-05-02 Completed Date: 2006-05-24 Revised Date: 2007-11-14 |
Medline Journal Info:
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Nlm Unique ID: 100892005 Medline TA: J Acquir Immune Defic Syndr Country: United States |
Other Details:
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Languages: eng Pagination: 632-41 Citation Subset: IM; X |
Affiliation:
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Division of Infectious Diseases, School of Medicine, Falk Medical Building, University of Pittsburgh, 3601 Fifth Avenue, Pittsburgh, PA 15213, USA. abbasu@dom.pitt.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Acquired Immunodeficiency Syndrome
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drug therapy*,
epidemiology*,
mortality,
transmission* Africa South of the Sahara / epidemiology Anti-HIV Agents / therapeutic use* CD4 Lymphocyte Count Disease Progression Female HIV Infections / drug therapy*, epidemiology*, mortality, transmission Health Care Rationing Humans Male Prevalence Sensitivity and Specificity Sexual Behavior South Africa / epidemiology Uncertainty World Health Organization |
| Grant Support | |
ID/Acronym/Agency:
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1 R21 AI064092-01A1/AI/NIAID NIH HHS; U01 AI 38858/AI/NIAID NIH HHS; //Wellcome Trust |
| Chemical | |
Reg. No./Substance:
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0/Anti-HIV Agents |
| Comments/Corrections | |
Erratum In:
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J Acquir Immune Defic Syndr. 2006 Jun;42(2):262 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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