The need for second-line antiretroviral therapy in adults in sub-Saharan Africa up to 2030: a mathematical modelling study
作者： Janne Estill , Nathan Ford , Luisa Salazar-Vizcaya , Andreas D Haas , Nello Blaser
DOI: 10.1016/S2352-3018(16)00016-3
关键词: Intensive care medicine 、 Population 、 Human immunodeficiency virus (HIV) 、 Pediatrics 、 Hiv transmission 、 Second line 、 Developing country 、 Antiretroviral therapy 、 Sub saharan 、 Viral load 、 Medicine
摘要: Summary Background The number of patients in need second-line antiretroviral drugs is increasing sub-Saharan Africa. We aimed to project the therapy adults Africa up 2030. Methods developed a simulation model for HIV and applied it each African country. used WHO country intelligence database estimate adult receiving from 2005 2014. fitted observed estimates, predicted first-line needs between 2015 present results Africa, eight selected countries. 18 scenarios, combining availability viral load monitoring, speed scale-up, rates retention switching second-line. transmission was not included. Findings Depending on scenario, 8·7–25·6 million people are expected receive 2020, whom 0·5–3·0 will be therapy. proportion treatment highest (15·6%) scenario with perfect immediate switching, no further universal routine monitoring. In 2030, estimated range remain constant, but increase 0·8–4·6 (6·6–19·6%). two three times higher if monitoring implemented throughout region, compared scale-up. For strategy, future differed only minimally Interpretation Donors countries should prepare substantial during next few years as access improves. An urgent exists decrease costs drugs. Funding World Health Organization, Swiss National Science Foundation, Institutes Health.
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