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Review
. 2020 Feb;17(1):26-34.
doi: 10.1007/s11904-019-00478-x.

Optimizing Treatment for Adults with HIV/AIDS in China: Successes over Two Decades and Remaining Challenges

Wei Cao  1 , Evelyn Hsieh  1   2 , Taisheng Li  3
Affiliations
Review

Optimizing Treatment for Adults with HIV/AIDS in China: Successes over Two Decades and Remaining Challenges

Wei Cao et al. Curr HIV/AIDS Rep. 2020 Feb.

Abstract

Purpose of review: The introduction of the National Free Antiretroviral Therapy Program (NFATP) in 2003 by the China National Center for AIDS/STD Control and Prevention has led to dramatic increases in antiretroviral therapy (ART) coverage among HIV-infected Chinese patients. Despite limitations in the number of available free antiretroviral drugs, the overall mortality associated with HIV/AIDS has dropped from 39.3 per 100 person-years in 2002 to 3.1 in 2014. In this review, we summarize the challenges, responses, and achievements of antiretroviral therapy (ART) in China over the past 20 years.

Recent findings: Continuous optimization of the Chinese National Guidelines for HIV/AIDS Diagnosis and Treatment has been guided by data from serial domestic multi-center studies aimed at evaluating efficacy and toxicity of available ART regimens among Chinese patients with HIV, with the goal of maximizing adherence, access, and efficacy. In addition, increasing attention has been focused on the importance of continuity in the HIV care cascade to promote linkage to care, and address the multidisciplinary chronic care needs HIV/AIDS patients on lifelong ART. Great progress has been achieved in the past 20 years in terms of access to and optimization of antiretroviral treatment in China. As the number of patients receiving long-term ART continues to grow, the focus of HIV/AIDS treatment has gradually transitioned from urgent care to the management of non-AIDS-related chronic complications and control of chronic inflammation.

Keywords: Acquired immune deficiency syndrome; Continuum of care; Highly active antiretroviral therapy; Human immunodeficiency virus; Multidisciplinary care; National Free Antiretroviral Treatment Program.

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Conflict of interest statement

Wei Cao and Taisheng Li declare no conflicts of interest. Dr. Hsieh has previously received honoraria from Gilead, unrelated to this manuscript.

Figures

Fig. 1
Fig. 1
Structure of care delivery and budgetary responsibilities at different administrative levels of the NFATP. Adapted from [4]
Fig. 2
Fig. 2
Proposed model for comprehensive management of HIV/AIDS in China
See this image and copyright information in PMC

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