Antiretroviral therapy (ART) for the treatment of HIV infection has saved 2.8 million years of life in South Africa since 2004 and is projected to save an additional 15.1 million years of life by 2030, according to a new study published online in The Journal of Infectious Diseases.
The analysis suggests these dramatic benefits could be even greater if more aggressive HIV testing and treatment strategies are implemented.
"We hope that this study reminds stakeholders of the astounding efficacy of the global ART rollout while simultaneously invigorating efforts to redouble commitments toward expanding the availability of ART," said lead study author Michael D. April, MD, DPhil, of the San Antonio Uniformed Services Health Education Consortium.
South Africa's HIV epidemic is the largest in the world, with an estimated 5.6 million people infected in 2011, according to UNAIDS. Although about half of those infected are eligible for treatment with ART, based on current guidelines for when to start therapy, one-third of those eligible remain without treatment, despite progress in expanding access since ART was introduced in the country in 2004. In this study, researchers used a mathematical model based on real world data to quantify the direct impact of the rollout of ART on survival among HIV-infected patients.
The researchers estimated that substantial survival gains from ART have already been achieved in South Africa: 2.8 million years of life gained as of December 2011. These years of life already saved represent just 15.6 percent of the 17.9 million years of life that will be saved by 2030 among patients currently receiving ART, according to the researchers' analysis.
Notably, these estimates exclude those who might benefit from starting ART in the future but who are not yet receiving it, Dr. April said. Continued international investment in the global response to HIV, including the U.S. President's Plan for Emergency AIDS Relief (PEPFAR), will be required to maintain the gains already achieved and efficiently expand access to ART. "Policymakers have the power to magnify the future trajectory of survival gains further still by pursuing more aggressive HIV testing and treatment strategies," Dr. April noted. "Increased case identification, early ART initiation, and expanded treatment options might catapult our conservative survival projections even further."
Despite earlier political decisions to limit ART scale-up in South Africa, the country's aggregate survival benefit from ART during just eight years (2004-2011) is similar to the considerable benefit reported previously for the U.S. over 15 years (1989-2003), wrote Sten H. Vermund, MD, PhD, of Vanderbilt University in Nashville, in an accompanying editorial commentary.
"The magnitude of the benefit of South African ART-based programs is astounding," wrote Dr. Vermund, who noted his hope that the bipartisanship in the U.S. that has characterized support of PEPFAR, which has been instrumental in the fight against HIV in sub-Saharan Africa, "will continue to bolster this essential investment for the future of the African continent."
The findings underscore the need to maintain the successes of an effective ART delivery system that today provides treatment for 1.4 million HIV-infected South Africans who need it—and to build on these accomplishments, the study authors said. National surveys suggest that only half of South Africans have ever been tested for HIV; there are likely large numbers of people infected with HIV in the high prevalence country that have yet to be identified and linked to lifesaving care.
"Our results suggest that rather than a debate over continuation of current funding commitments for the global response to HIV, policymakers and researchers should be examining strategies to most effectively and efficiently expand HIV testing and treatment efforts, to help increase future potential survival gains," said study author Rochelle P. Walensky, MD, MPH, of Massachusetts General Hospital and Harvard Medical School.
1. Researchers used a mathematical model based on real world data to quantify the direct impact of the rollout of antiretroviral therapy (ART) on survival among HIV-infected patients in South Africa.
2. ART has saved 2.8 million years of life in South Africa since 2004 and is projected to save an additional 15.1 million years of life by 2030.
3. These conservative estimates exclude those who might benefit from ART in the future. More aggressive HIV testing and treatment strategies could save even more years of life, if supported by ongoing international efforts to combat HIV.
NOTE: For a copy of the study and related editorial, which are embargoed until 12:01 a.m. EST on Wednesday, Dec. 4, please contact Jerica Pitts at email@example.com or 312-558-1770.
Published continuously since 1904, The Journal of Infectious Diseases is the premier global journal for original research on infectious diseases. The editors welcome major articles and brief reports describing research results on microbiology, immunology, epidemiology, and related disciplines, on the pathogenesis, diagnosis, and treatment of infectious diseases; on the microbes that cause them; and on disorders of host immune responses. The journal is an official publication of the Infectious Diseases Society of America (IDSA). Based in Arlington, Va., IDSA is a professional society representing nearly 10,000 physicians and scientists who specialize in infectious diseases.
The personality factor: How to foster the sharing of research data
06.09.2017 | ZBW – Leibniz-Informationszentrum Wirtschaft
Europe’s Demographic Future. Where the Regions Are Heading after a Decade of Crises
10.08.2017 | Berlin-Institut für Bevölkerung und Entwicklung
Plants and algae use the enzyme Rubisco to fix carbon dioxide, removing it from the atmosphere and converting it into biomass. Algae have figured out a way to increase the efficiency of carbon fixation. They gather most of their Rubisco into a ball-shaped microcompartment called the pyrenoid, which they flood with a high local concentration of carbon dioxide. A team of scientists at Princeton University, the Carnegie Institution for Science, Stanford University and the Max Plank Institute of Biochemistry have unravelled the mysteries of how the pyrenoid is assembled. These insights can help to engineer crops that remove more carbon dioxide from the atmosphere while producing more food.
A warming planet
Our brains house extremely complex neuronal circuits, whose detailed structures are still largely unknown. This is especially true for the so-called cerebral cortex of mammals, where among other things vision, thoughts or spatial orientation are being computed. Here the rules by which nerve cells are connected to each other are only partly understood. A team of scientists around Moritz Helmstaedter at the Frankfiurt Max Planck Institute for Brain Research and Helene Schmidt (Humboldt University in Berlin) have now discovered a surprisingly precise nerve cell connectivity pattern in the part of the cerebral cortex that is responsible for orienting the individual animal or human in space.
The researchers report online in Nature (Schmidt et al., 2017. Axonal synapse sorting in medial entorhinal cortex, DOI: 10.1038/nature24005) that synapses in...
Whispering gallery mode (WGM) resonators are used to make tiny micro-lasers, sensors, switches, routers and other devices. These tiny structures rely on a...
Using ultrafast flashes of laser and x-ray radiation, scientists at the Max Planck Institute of Quantum Optics (Garching, Germany) took snapshots of the briefest electron motion inside a solid material to date. The electron motion lasted only 750 billionths of the billionth of a second before it fainted, setting a new record of human capability to capture ultrafast processes inside solids!
When x-rays shine onto solid materials or large molecules, an electron is pushed away from its original place near the nucleus of the atom, leaving a hole...
For the first time, physicists have successfully imaged spiral magnetic ordering in a multiferroic material. These materials are considered highly promising candidates for future data storage media. The researchers were able to prove their findings using unique quantum sensors that were developed at Basel University and that can analyze electromagnetic fields on the nanometer scale. The results – obtained by scientists from the University of Basel’s Department of Physics, the Swiss Nanoscience Institute, the University of Montpellier and several laboratories from University Paris-Saclay – were recently published in the journal Nature.
Multiferroics are materials that simultaneously react to electric and magnetic fields. These two properties are rarely found together, and their combined...
19.09.2017 | Event News
12.09.2017 | Event News
06.09.2017 | Event News
22.09.2017 | Life Sciences
22.09.2017 | Medical Engineering
22.09.2017 | Physics and Astronomy