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. 2014 Nov;28 Suppl 4(4):S445-51.
doi: 10.1097/QAD.0000000000000481.

Estimating future trends in paediatric HIV

Martina Penazzato  1 , Victoria Bendaud, Lisa Nelson, John Stover, Mary Mahy
Affiliations

Estimating future trends in paediatric HIV

Martina Penazzato et al. AIDS. 2014 Nov.

Abstract

Background: Paediatric treatment continues to lag behind adult treatment and significant efforts are urgently needed to scale up antiretroviral therapy (ART) for children. As efforts to prevent mother-to-child transmission expand, better understanding of future trends and age characterization of the population that will be in need of ART is needed to inform policymakers, as well as drug developers and manufacturers.

Methods: The Spectrum model was used to estimate the total number of expected paediatric infections by 2020 in 21 priority countries in Africa. Different ART scale-up scenarios were investigated and age characterization of the population was explored.

Results: By 2020, new paediatric infections in the 21 countries will decline in all the scenarios. Total paediatric infections will also decline in the 21 high-burden countries, but with a differential effect by scenario and age group. On the basis of the optimal scale-up scenario, 1 940 000 [1 760 000-2 120 000] children will be expected to be living with HIV in 2020. The number of children dying of AIDS is notably different in the three models. Assuming optimal scale-up and based on 2013 treatment initiation criteria, the estimates of children to receive ART in the 21 high-burden countries will increase to 1 670 000 (1 500 000-1 800 000).

Conclusion: By 2020, even under the most optimistic scenarios, a considerable number of children will still be living with HIV. Age-appropriate drugs and formulations will be needed to meet the treatment needs of this vulnerable population. Improved estimates will be critical to guide the development and forecasting of commodities to close the existing paediatric treatment gap.

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Figures

Fig. 1
Fig. 1
Components of Spectrum model to estimate paediatric treatment needs.
Fig. 2
Fig. 2
Estimated annual new child infections by scenarios (2010–2020, 21 priority countries).
Fig. 3
Fig. 3
Number of children living with HIV by age group (2010–2020, 21 priority countries).
Fig. 4
Fig. 4
Number of children living with HIV under the age of 15, by scenario (2020, 21 priority countries).
See this image and copyright information in PMC

References

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    1. The UNAIDS Gap Report. UNAIDS; 2014. www.unaids.org/en/media/unaids/contentassets/documents/unaidspublication....
    1. World Health Organization. March 2014 supplement to the 2013 consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection. Geneva; 2014. - PubMed
    1. World Health Organization. Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection. Geneva: World Health Organization; 2013, www.who.int/hiv/pub/guidelines/arv2013. - PubMed

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