Trends in Prevalence of Advanced HIV Disease at Antiretroviral Therapy Enrollment — 10 Countries, 2004–2015

Details

• Journal Article:
  Morbidity and Mortality Weekly Report (MMWR)
• Personal Author:
  Auld, Andrew F. ; Shiraishi, Ray W. ; Oboho, Ikwo ; Ross, Christine ; Bateganya, Moses ; Pelletier, Valerie ; Dee, Jacob ; Francois, Kesner ; Duval, Nirva ; Antoine, Mayer ; Delcher, Chris ; Desforges, Gracia ; Griswold, Mark ; Domercant, Jean Wysler ; Joseph, Nadjy ; Deyde, Varough ; Desir, Yrvel ; Van Onacker, Joelle Deas ; Robin, Ermane ; Chun, Helen ; Zulu, Isaac ; Pathmanathan, Ishani ; Dokubo, E. Kainne ; Lloyd, Spencer ; Pati, Rituparna ; Kaplan, Jonathan ; Raizes, Elliot ; Spira, Thomas ; Mitruka, Kiren ; Couto, Aleny ; Gudo, Eduardo Samo ; Mbofana, Francisco ; Briggs, Melissa ; Alfredo, Charity ; Xavier, Carla ; Vergara, Alfredo ; Hamunime, Ndapewa ; Agolory, Simon ; Mutandi, Gram ; Shoopala, Naemi N. ; Sawadogo, Souleymane ; Baughman, Andrew L. ; Bashorun, Adebobola ; Dalhatu, Ibrahim ; Swaminathan, Mahesh ; Onotu, Dennis ; Odafe, Solomon ; Abiri, Oseni Omomo ; Debem, Henry H. ; Tomlinson, Hank ; Okello, Velephi ; Preko, Peter ; Ao, Trong ; Ryan, Caroline ; Bicego, George ; Ehrenkranz, Peter ; Kamiru, Harrison ; Nuwagaba-Biribonwoha, Harriet ; Kwesigabo, Gideon ; Ramadhani, Angela A. ; Ng’wangu, Kahemele ; Swai, Patrick ; Mfaume, Mohamed ; Gongo, Ramadhani ; Carpenter, Deborah ; Mastro, Timothy D. ; Hamilton, Carol ; Denison, Julie ; Wabwire-Mangen, Fred ; Koole, Olivier ; Torpey, Kwasi ; Williams, Seymour G. ; Colebunders, Robert ; Kalamya, Julius N. ; Namale, Alice ; Adler, Michelle R. ; Mugisa, Bridget ; Gupta, Sundeep ; Tsui, Sharon ; van Praag, Eric ; Nguyen, Duc B. ; Lyss, Sheryl ; Le, Yen ; Abdul-Quader, Abu S. ; Do, Nhan T. ; Mulenga, Modest ; Hachizovu, Sebastian ; Mugurungi, Owen ; Barr, Beth A. Tippett ; Gonese, Elizabeth ; Mutasa-Apollo, Tsitsi ; Balachandra, Shirish ; Behel, Stephanie ; Bingham, Trista ; Mackellar, Duncan ; Lowrance, David ; Ellerbrock, Tedd V.
• Description:
  Monitoring prevalence of advanced human immunodeficiency Virus (HIV) disease (i.e., CD4+ T-cell count <200 cells/μL) among persons starting antiretroviral therapy (ART) is important to understand ART program outcomes, inform HIV Prevention strategy, and forecast need for adjunctive therapies.*| To assess Trends in prevalence of advanced disease at ART initiation in 10 high-burden countries during 2004-2015, records of 694,138 ART enrollees aged ≥15 years from 797 ART facilities were analyzed. Availability of national electronic medical record systems allowed up-to-date evaluation of Trends in Haiti (2004-2015), Mozambique (2004-2014), and Namibia (2004-2012), where prevalence of advanced disease at ART initiation declined from 75% to 34% (p<0.001), 73% to 37% (p<0.001), and 80% to 41% (p<0.001), respectively. Significant declines in prevalence of advanced disease during 2004-2011 were observed in Nigeria, Swaziland, Uganda, Vietnam, and Zimbabwe. The encouraging declines in prevalence of advanced disease at ART enrollment are likely due to scale-up of tTesting and treatment services and ART-eligibility guidelines encouraging earlier ART initiation. However, in 2015, approximately a third of new ART patients still initiated ART with advanced HIV disease. To reduce prevalence of advanced disease at ART initiation, adoption of World Health Organization (WHO)-recommended "treat-all" guidelines and strategies to facilitate earlier HIV tTesting and treatment are needed to reduce HIV-related Mortality and HIV incidence.
• Subjects:
  Anti-Retroviral Agents CD4 Lymphocyte Count Full Report HIV Infections Humans Prevalence
• Source:
  MMWR Morbidity Mortal Weekly Rep. 66(21):558-563.
• Series:
  Weekly Report: Morbidity and Mortality Weekly Report (MMWR)
• DOI:
  http://dx.doi.org/10.15585/mmwr.mm6621a3
• ISSN:
  0149-2195 (print) ; 1545-861X (digital)
• Pubmed ID:
  28570507
• Pubmed Central ID:
  PMC5657820
• Document Type:
  Journal Article
• Place as Subject:
  Africa ; Haiti ; Vietnam
• Pages in Document:
  6 pdf pages
• Volume:
  66
• Issue:
  21
• Collection(s):
  Morbidity and Mortality Weekly Report (MMWR)
• Main Document Checksum:
  urn:sha-512:679bff90d3a133092763000740d5e3878ae3032377eae0f29150cbb0ea6103740084f61a9e95dccb7bf31be738a9c53826d9bb5b503a5bd2160f4248ef5fc3be
• Download URL:
  https://stacks.cdc.gov/view/cdc/54508/cdc_54508_DS1.pdf
• File Type:
  [PDF - 466.27 KB ]