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Editorial
. 2018 Nov 15;4(Suppl 2):1-4.
doi: 10.1016/S2055-6640(20)30340-X.

Treating all people living with HIV in sub-Saharan Africa: a new era calling for new approaches

Denis Nash, Marcel Yotebieng  1 , Annette H Sohn  2
Affiliations
Editorial

Treating all people living with HIV in sub-Saharan Africa: a new era calling for new approaches

Denis Nash et al. J Virus Erad. .

Abstract

Nearly all countries in sub-Saharan Africa (SSA) have adopted national policies to treat all persons with HIV, regardless of CD4 cell count or clinical stage ('treat all'). With 10.3 million people untreated and a projected 1.2 million new infections per year in SSA, the current and anticipated unmet need for HIV treatment in SSA is substantial. Evidence to date from SSA suggests that, once linked to care, timely ART initiation with retention and viral suppression is the norm. However, ART initiation in SSA usually occurs late in the course of infection, driving high mortality and incidence rates. The 'treat all' era presents strategic opportunities for health systems to substantially reduce AIDS-related mortality and HIV incidence. This special issue of the Journal of Virus Eradication contains eight articles focused on issues critical to ensuring the success and impact of 'treat all' implementation in SSA.

Keywords: HIV, ‘treat all’, sub-Saharan Africa, HIV treatment guidelines.

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Figures

Figure 1.
Figure 1.
HIV care continuum and number of people with untreated HIV in sub-Saharan Africa, 2017. Adapted from UNAIDS 2018 estimates .
Figure 2.
Figure 2.
Trends in HIV incidence and deaths in sub-Saharan Africa, 1990–2017. (a) Eastern and southern Africa; (b) western and central Africa. Source: UNAIDS 2018 estimates .
Figure 3.
Figure 3.
Uptake of WHO policy for ‘treat all’ ART initiation among adults and adolescents living with HIV (situation as of mid-2018). Map provided by courtesy of WHO (Global AIDS Monitoring [UNAIDS/WHO/UNICEF] and WHO HIV country intelligence tool, 2018).
See this image and copyright information in PMC

References

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    1. WHO Uptake of WHO policy for Treat All ART initiation among adults and adolescents living with HIV (situation as of mid-2018). Personal communication to D Nash, 2018.
    1. Bor J, Fox MP, Rosen S et al. . Treatment eligibility and retention in clinical HIV care: a regression discontinuity study in South Africa. PLoS Med 2017; 14: e1002463. - PMC - PubMed

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