Using age-specific mortality of HIV infected persons to predict anti-retroviral treatment need: a comparative analysis of data from five African population-based cohort studies
Objectives To present a simple method for estimating population-level anti-retroviral therapy (ART) need that does not rely on knowledge of past HIV incidence. Methods A new approach to estimating ART need is developed based on calculating age-specific proportions of HIV-infected adults expected t...
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| Main Authors: | , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
30 July 2012
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| In: |
Tropical medicine & international health
Year: 2012, Volume: 17, Issue: 8, Pages: e3-e14 |
| ISSN: | 1365-3156 |
| DOI: | 10.1111/j.1365-3156.2011.02943.x |
| Online Access: | Verlag, kostenfrei, Volltext: http://dx.doi.org/10.1111/j.1365-3156.2011.02943.x Verlag, kostenfrei, Volltext: http://onlinelibrary.wiley.com/doi/10.1111/j.1365-3156.2011.02943.x/abstract 
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| Author Notes: | Basia Żaba, Ivan Kasamba, Sian Floyd, Raphael Isingo, Kobus Herbst, Till Bärnighausen, Simon Gregson, Constance Nyamukapa, Ndoliwe Kayuni, Jim Todd, Milly Marston, Alison Wringe |
| Summary: | Objectives To present a simple method for estimating population-level anti-retroviral therapy (ART) need that does not rely on knowledge of past HIV incidence. Methods A new approach to estimating ART need is developed based on calculating age-specific proportions of HIV-infected adults expected to die within a fixed number of years in the absence of treatment. Mortality data for HIV-infected adults in the pre-treatment era from five African HIV cohort studies were combined to construct a life table, starting at age 15, smoothed with a Weibull model. Assuming that ART should be made available to anyone expected to die within 3 years, conditional 3-year survival probabilities were computed to represent proportions needing ART. The build-up of ART need in a successful programme continuously recruiting infected adults into treatment as they age to within 3 years of expected death was represented by annually extending the conditional survival range. Results The Weibull model: survival probability in the infected state from age 15 = exp(−0.0073 × (age − 15)1.69) fitted the pooled age-specific mortality data very closely. Initial treatment need for infected persons increased rapidly with age, from 15% at age 20-24 to 32% at age 40-44 and 42% at age 60-64. Overall need in the treatment of naïve population was 24%, doubling within 5 years in a programme continually recruiting patients entering the high-risk period for dying. Conclusion A reasonable projection of treatment need in an ART naive population can be made based on the age and gender profile of HIV-infected people. |
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| Item Description: | Gesehen am 26.10.2017 |
| Physical Description: | Online Resource |
| ISSN: | 1365-3156 |
| DOI: | 10.1111/j.1365-3156.2011.02943.x |