PMID- 16652038
OWN - NLM
STAT- MEDLINE
DCOM- 20060524
LR  - 20200930
IS  - 1525-4135 (Print)
IS  - 1525-4135 (Linking)
VI  - 41
IP  - 5
DP  - 2006 Apr 15
TI  - Potential impact of antiretroviral therapy on HIV-1 transmission and AIDS 
      mortality in resource-limited settings.
PG  - 632-41
AB  - 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.
FAU - Abbas, Ume L
AU  - Abbas UL
AD  - Division of Infectious Diseases, School of Medicine, Falk Medical Building, 
      University of Pittsburgh, 3601 Fifth Avenue, Pittsburgh, PA 15213, USA. 
      abbasu@dom.pitt.edu
FAU - Anderson, Roy M
AU  - Anderson RM
FAU - Mellors, John W
AU  - Mellors JW
LA  - eng
GR  - 1 R21 AI064092-01A1/AI/NIAID NIH HHS/United States
GR  - U01 AI 38858/AI/NIAID NIH HHS/United States
GR  - Wellcome Trust/United Kingdom
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Acquir Immune Defic Syndr
JT  - Journal of acquired immune deficiency syndromes (1999)
JID - 100892005
RN  - 0 (Anti-HIV Agents)
SB  - IM
EIN - J Acquir Immune Defic Syndr. 2006 Jun;42(2):262
MH  - Acquired Immunodeficiency Syndrome/*drug 
      therapy/*epidemiology/mortality/*transmission
MH  - Africa South of the Sahara/epidemiology
MH  - Anti-HIV Agents/*therapeutic use
MH  - CD4 Lymphocyte Count
MH  - Disease Progression
MH  - Female
MH  - HIV Infections/*drug therapy/*epidemiology/mortality/transmission
MH  - Health Care Rationing
MH  - Humans
MH  - Male
MH  - Prevalence
MH  - Sensitivity and Specificity
MH  - Sexual Behavior
MH  - South Africa/epidemiology
MH  - Uncertainty
MH  - World Health Organization
EDAT- 2006/05/03 09:00
MHDA- 2006/05/25 09:00
CRDT- 2006/05/03 09:00
PHST- 2006/05/03 09:00 [pubmed]
PHST- 2006/05/25 09:00 [medline]
PHST- 2006/05/03 09:00 [entrez]
AID - 00126334-200604150-00013 [pii]
AID - 10.1097/01.qai.0000194234.31078.bf [doi]
PST - ppublish
SO  - J Acquir Immune Defic Syndr. 2006 Apr 15;41(5):632-41. doi: 
      10.1097/01.qai.0000194234.31078.bf.