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. 2010 Dec;86 Suppl 2(Suppl_2):ii62-6.
doi: 10.1136/sti.2010.046177.

Antiretroviral therapy needs: the effect of changing global guidelines

Karen Stanecki  1 , Juliana Daher, John Stover, Michel Beusenberg, Yves Souteyrand, Jesus M García Calleja
Affiliations

Antiretroviral therapy needs: the effect of changing global guidelines

Karen Stanecki et al. Sex Transm Infect. 2010 Dec.

Abstract

Background: In 2010 the WHO issued a revision of the guidelines on antiretroviral therapy (ART) for HIV infection in adults and adolescents. The recommendations included earlier diagnosis and treatment of HIV in the interest of a longer and healthier life. The current analysis explores the impact on the estimates of treatment needs of the new criteria for initiating ART compared with the previous guidelines.

Methods: The analyses are based on the national models of HIV estimates for the years 1990-2009. These models produce time series estimates of ART treatment need and HIV-related mortality. The ART need estimates based on ART eligibility criteria promoted by the 2010 WHO guidelines were compared with the need estimates based on the 2006 WHO guidelines.

Results: With the 2010 eligibility criteria, the proportion of people living with HIV currently in need of ART is estimated to increase from 34% to 49%. Globally, the need increases from 11.4 million (10.2-12.5 million) to 16.2 million (14.8-17.1 million). Regional differences include 7.4 million (6.4-8.4 million) to 10.6 million (9.7-11.5 million) in sub-Saharan Africa, 1.6 million (1.3-1.7 million) to 2.4 million (2.1-2.5 million) in Asia and 710 000 (610 000-780 000) to 950 000 (810 000-1.0 million) in Latin America and the Caribbean.

Conclusions: When adopting the new recommendations, countries have to adapt their planning process in order to accelerate access to life saving drugs to those in need. These recommendations have a significant impact on resource needs. In addition to improving and prolonging the lives of the infected individuals, it will have the expected benefit of reducing HIV transmission and the future HIV/AIDS burden.

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Conflict of interest statement

Competing interests: None.

Figures

Figure 1
Figure 1
Global number of adults (≥15 years) eligible for antiretroviral therapy (ART) in low- and middle-income countries in 1990–2009 according to WHO guidelines for 2006 and 2009.
Figure 2
Figure 2
Number of adults (≥15 years) eligible for antiretroviral therapy (ART) by region in 1990–2009 according to WHO guidelines for 2006 and 2010.
Figure 3
Figure 3
Number of adults (≥15 years) in sub-Saharan Africa eligible for ART by country in 2009 according to WHO guidelines for 2006 and 2010.
See this image and copyright information in PMC

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