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Trends in Prevalence of Advanced HIV Disease at Antiretroviral Therapy Enrollment — 10 Countries, 2004–2015
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Jun 02 2017
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Source: MMWR Morbidity Mortal Weekly Rep. 66(21):558-563.
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Journal Article:Morbidity and Mortality Weekly Report (MMWR)
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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.
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ISSN:0149-2195 (print);1545-861X (digital);
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Pubmed ID:28570507
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Pubmed Central ID:PMC5657820
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Pages in Document:6 pdf pages
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Volume:66
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Issue:21
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