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Trends in AIDS Deaths, New Infections and ART Coverage in the Top 30 Countries with the Highest AIDS Mortality Burden; 1990-2013.

Granich R, Gupta S, Hersh B, Williams B, Montaner J, Young B, Zuniga JM - PLoS ONE (2015)

Bottom Line: ART access in 2013 has averted as estimated 1,051,354 and 422,448 deaths in South Africa and Nigeria, respectively.Over the past decade the expansion of access to ART averted millions of deaths.Reaching the proposed UN 90-90-90 Target by 2020 will prevent additional morbidity, mortality and HIV transmission.

View Article: PubMed Central - PubMed

Affiliation: International Association of Providers of AIDS Care, Washington D.C., United States of America.

ABSTRACT

Background: Antiretroviral therapy (ART) prevents human immunodeficiency virus (HIV) disease progression, mortality and transmission. We assess the impact of expanded HIV treatment for the prevention of Acquired Immunodeficiency Syndrome (AIDS)-related deaths and simulate four treatment scenarios for Nigeria and South Africa.

Methods: For 1990-2013, we used the Joint United Nations Programme on HIV/AIDS (UNAIDS) database to examine trends in AIDS deaths, HIV incidence and prevalence, ART coverage, annual AIDS death rate, AIDS death-to-treatment and HIV infections to treatment ratios for the top 30 countries with the highest AIDS mortality burden and compare them with data from high-income countries. We projected the 1990-2020 AIDS deaths for Nigeria and South Africa using four treatment scenarios: 1) no ART; 2) maintaining current ART coverage; 3) 90% ART coverage based on 2013 World Health Organization (WHO) ART guidelines by 2020; and 4) reaching the United Nations 90-90-90 Target by 2020.

Findings: In 2013, there were 1.3 million (1.1 million-1.6 million) AIDS deaths in the top 30 countries representing 87% of global AIDS deaths. Eight countries accounted for 58% of the global AIDS deaths; Nigeria and South Africa accounted for 27% of global AIDS deaths. The highest death rates per 1000 people living with HIV were in Central African Republic (91), South Sudan (82), Côte d'Ivoire (75), Cameroon (72) and Chad (71), nearly 8-10 times higher than the high-income countries. ART access in 2013 has averted as estimated 1,051,354 and 422,448 deaths in South Africa and Nigeria, respectively. Increasing ART coverage in these two countries to meet the proposed UN 90-90-90 Target by 2020 could avert 2.2 and 1.2 million deaths, respectively.

Interpretation: Over the past decade the expansion of access to ART averted millions of deaths. Reaching the proposed UN 90-90-90 Target by 2020 will prevent additional morbidity, mortality and HIV transmission. Despite progress, high-burden countries will need to accelerate access to ART treatment to avert millions of premature AIDS deaths and new HIV infections.

No MeSH data available.


Related in: MedlinePlus

Estimated annual AIDS-related deaths by country, 2013.Number and percentage of estimated 1.5 million (1.4 million–1.7 million) global AIDS-related deaths in the eight highest burden countries for 2013.
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pone.0131353.g001: Estimated annual AIDS-related deaths by country, 2013.Number and percentage of estimated 1.5 million (1.4 million–1.7 million) global AIDS-related deaths in the eight highest burden countries for 2013.

Mentions: Of an estimated 1.5 million (1.4 million–1.7 million) AIDS-related deaths globally in 2013, the top 30 countries with the highest AIDS mortality in 2013 accounted for 1.3 million (1.1 million–1.6 million) or 87% of total AIDS-related deaths. All but three countries (Brazil, Ukraine and Haiti) belong to two regions: Sub-Saharan Africa and Asia and the Pacific, the regions with the highest numbers of AIDS-related deaths. Only eight countries (Nigeria, South Africa, India, Mozambique, Tanzania, Zimbabwe, Uganda and Kenya) accounted for 58% of the global AIDS-related deaths in 2013 (Fig 1). The estimated annual AIDS-related deaths in the top 30 countries rose from 260,000 (200,000–360,000) in 1990 to peak at 2.1 million (1.8 million–2.3 million) in 2005 (Data not shown). Since 2005, AIDS deaths have been declining, representing a 36% decline in annual estimated AIDS deaths. Compared to the new HIV infections, which peaked at 3.1 million (2.7 million–3.6 million) in 1997, the peak in AIDS-related deaths occurred nearly a decade later.


Trends in AIDS Deaths, New Infections and ART Coverage in the Top 30 Countries with the Highest AIDS Mortality Burden; 1990-2013.

Granich R, Gupta S, Hersh B, Williams B, Montaner J, Young B, Zuniga JM - PLoS ONE (2015)

Estimated annual AIDS-related deaths by country, 2013.Number and percentage of estimated 1.5 million (1.4 million–1.7 million) global AIDS-related deaths in the eight highest burden countries for 2013.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4493077&req=5

pone.0131353.g001: Estimated annual AIDS-related deaths by country, 2013.Number and percentage of estimated 1.5 million (1.4 million–1.7 million) global AIDS-related deaths in the eight highest burden countries for 2013.
Mentions: Of an estimated 1.5 million (1.4 million–1.7 million) AIDS-related deaths globally in 2013, the top 30 countries with the highest AIDS mortality in 2013 accounted for 1.3 million (1.1 million–1.6 million) or 87% of total AIDS-related deaths. All but three countries (Brazil, Ukraine and Haiti) belong to two regions: Sub-Saharan Africa and Asia and the Pacific, the regions with the highest numbers of AIDS-related deaths. Only eight countries (Nigeria, South Africa, India, Mozambique, Tanzania, Zimbabwe, Uganda and Kenya) accounted for 58% of the global AIDS-related deaths in 2013 (Fig 1). The estimated annual AIDS-related deaths in the top 30 countries rose from 260,000 (200,000–360,000) in 1990 to peak at 2.1 million (1.8 million–2.3 million) in 2005 (Data not shown). Since 2005, AIDS deaths have been declining, representing a 36% decline in annual estimated AIDS deaths. Compared to the new HIV infections, which peaked at 3.1 million (2.7 million–3.6 million) in 1997, the peak in AIDS-related deaths occurred nearly a decade later.

Bottom Line: ART access in 2013 has averted as estimated 1,051,354 and 422,448 deaths in South Africa and Nigeria, respectively.Over the past decade the expansion of access to ART averted millions of deaths.Reaching the proposed UN 90-90-90 Target by 2020 will prevent additional morbidity, mortality and HIV transmission.

View Article: PubMed Central - PubMed

Affiliation: International Association of Providers of AIDS Care, Washington D.C., United States of America.

ABSTRACT

Background: Antiretroviral therapy (ART) prevents human immunodeficiency virus (HIV) disease progression, mortality and transmission. We assess the impact of expanded HIV treatment for the prevention of Acquired Immunodeficiency Syndrome (AIDS)-related deaths and simulate four treatment scenarios for Nigeria and South Africa.

Methods: For 1990-2013, we used the Joint United Nations Programme on HIV/AIDS (UNAIDS) database to examine trends in AIDS deaths, HIV incidence and prevalence, ART coverage, annual AIDS death rate, AIDS death-to-treatment and HIV infections to treatment ratios for the top 30 countries with the highest AIDS mortality burden and compare them with data from high-income countries. We projected the 1990-2020 AIDS deaths for Nigeria and South Africa using four treatment scenarios: 1) no ART; 2) maintaining current ART coverage; 3) 90% ART coverage based on 2013 World Health Organization (WHO) ART guidelines by 2020; and 4) reaching the United Nations 90-90-90 Target by 2020.

Findings: In 2013, there were 1.3 million (1.1 million-1.6 million) AIDS deaths in the top 30 countries representing 87% of global AIDS deaths. Eight countries accounted for 58% of the global AIDS deaths; Nigeria and South Africa accounted for 27% of global AIDS deaths. The highest death rates per 1000 people living with HIV were in Central African Republic (91), South Sudan (82), Côte d'Ivoire (75), Cameroon (72) and Chad (71), nearly 8-10 times higher than the high-income countries. ART access in 2013 has averted as estimated 1,051,354 and 422,448 deaths in South Africa and Nigeria, respectively. Increasing ART coverage in these two countries to meet the proposed UN 90-90-90 Target by 2020 could avert 2.2 and 1.2 million deaths, respectively.

Interpretation: Over the past decade the expansion of access to ART averted millions of deaths. Reaching the proposed UN 90-90-90 Target by 2020 will prevent additional morbidity, mortality and HIV transmission. Despite progress, high-burden countries will need to accelerate access to ART treatment to avert millions of premature AIDS deaths and new HIV infections.

No MeSH data available.


Related in: MedlinePlus