Using age-specific mortality of HIV infected persons to predict anti-retroviral treatment need

• Verfasst von: Zaba, Basia [VerfasserIn]
• Verfasst von: Floyd, Sian [VerfasserIn]
• Verfasst von: Herbst, Abraham Jacobus [VerfasserIn]
• Verfasst von: Bärnighausen, Till [VerfasserIn]
• Titel: Using age-specific mortality of HIV infected persons to predict anti-retroviral treatment need
• Titelzusatz: a comparative analysis of data from five African population-based cohort studies
• Verf.angabe: Basia Żaba, Ivan Kasamba, Sian Floyd, Raphael Isingo, Kobus Herbst, Till Bärnighausen, Simon Gregson, Constance Nyamukapa, Ndoliwe Kayuni, Jim Todd, Milly Marston, Alison Wringe
• E-Jahr: 2012
• Jahr: 30 July 2012
• Umfang: 12 S.
• Fussnoten: Gesehen am 26.10.2017
• Titel Quelle: Enthalten in: Tropical medicine & international health
• Ort Quelle: Oxford [u.a.] : Wiley-Blackwell, 1996
• Jahr Quelle: 2012
• Band/Heft Quelle: 17(2012), 8, Seite e3-e14
• ISSN Quelle: 1365-3156
• DOI: doi:10.1111/j.1365-3156.2011.02943.x
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Africa
• Sach-SW: AIDS
• Sach-SW: antiretroviral therapy
• Sach-SW: cohort studies
• Sach-SW: HIV
• Sach-SW: lifetable models
• Sach-SW: mortality
• K10plus-PPN: 1564829820

Abstract

Objectives  To present a simple method for estimating population-level anti-retroviral therapy (ART) need that does not rely on knowledge of past HIV incidence. Methods  A new approach to estimating ART need is developed based on calculating age-specific proportions of HIV-infected adults expected to die within a fixed number of years in the absence of treatment. Mortality data for HIV-infected adults in the pre-treatment era from five African HIV cohort studies were combined to construct a life table, starting at age 15, smoothed with a Weibull model. Assuming that ART should be made available to anyone expected to die within 3 years, conditional 3-year survival probabilities were computed to represent proportions needing ART. The build-up of ART need in a successful programme continuously recruiting infected adults into treatment as they age to within 3 years of expected death was represented by annually extending the conditional survival range. Results  The Weibull model: survival probability in the infected state from age 15 = exp(−0.0073 × (age − 15)1.69) fitted the pooled age-specific mortality data very closely. Initial treatment need for infected persons increased rapidly with age, from 15% at age 20-24 to 32% at age 40-44 and 42% at age 60-64. Overall need in the treatment of naïve population was 24%, doubling within 5 years in a programme continually recruiting patients entering the high-risk period for dying. Conclusion  A reasonable projection of treatment need in an ART naive population can be made based on the age and gender profile of HIV-infected people.