Trends in prevalence of advanced HIV disease at antiretroviral therapy enrollment - 10 countries, 2004-2015

Andrew F. Auld, Ray W. Shiraishi, Ikwo Oboho, Christine Ross, Moses Bateganya, Valerie Pelletier, Jacob Dee, Kesner Francois, Nirva Duval, Mayer Antoine, Chris Delcher, Gracia Desforges, Mark Griswold, Jean Wysler Domercant, Nadjy Joseph, Varough Deyde, Yrvel Desir, Joelle Deas Van Onacker, Ermane Robin, Helen ChunIsaac Zulu, Ishani Pathmanathan, E. Kainne Dokubo, Spencer Lloyd, Rituparna Pati, Jonathan Kaplan, Elliot Raizes, Thomas Spira, Kiren Mitruka, Aleny Couto, Eduardo Samo Gudo, Francisco Mbofana, Melissa Briggs, Charity Alfredo, Carla Xavier, Alfredo Vergara, Ndapewa Hamunime, Simon Agolory, Gram Mutandi, Naemi N. Shoopala, Souleymane Sawadogo, Andrew L. Baughman, Adebobola Bashorun, Ibrahim Dalhatu, Mahesh Swaminathan, Dennis Onotu, Solomon Odafe, Oseni Omomo Abiri, Henry H. Debem, Hank Tomlinson, Velephi Okello, Peter Preko, Trong Ao, Caroline Ryan, George Bicego, Peter Ehrenkranz, Harrison Kamiru, Harriet Nuwagaba-Biribonwoha, Gideon Kwesigabo, Angela A. Ramadhani, Kahemele Ng’wangu, Patrick Swai, Mohamed Mfaume, Ramadhani Gongo, Deborah Carpenter, Timothy D. Mastro, Carol Hamilton, Julie Denison, Fred Wabwire-Mangen, Olivier Koole, Kwasi Torpey, Seymour G. Williams, Robert Colebunders, Julius N. Kalamya, Alice Namale, Michelle R. Adler, Bridget Mugisa, Sundeep Gupta, Sharon Tsui, Eric Van Praag, Duc B. Nguyen, Sheryl Lyss, Yen Le, Abu S. Abdul-Quader, Nhan T. Do, Modest Mulenga, Sebastian Hachizovu, Owen Mugurungi, Beth A. Tippett Barr, Elizabeth Gonese, Tsitsi Mutasa-Apollo, Shirish Balachandra, Stephanie Behel, Trista Bingham, Duncan Mackellar, David Lowrance, Tedd V. Ellerbrock

Research output: Contribution to journalArticle

Abstract

What is already known about this topic? Monitoring prevalence of advanced human immunodeficiency virus (HIV) disease (i.e., CD4+ T-cell count <200 cells/µL) among persons initiating antiretroviral therapy (ART) is important to help understand ART program outcomes, inform HIV prevention strategies, and forecast need for adjunctive therapies. What is added by this report? In an analysis of 694,138 adult ART records from 10 countries, the prevalence of advanced disease at ART initiation during 2004-2015 declined in eight countries. In Mozambique (2004-2014), Namibia (2004-2012), and Haiti (2004-2015), prevalence of advanced disease at ART initiation declined from 73% to 37% (p<0.001), 80% to 41% (p<0.001), and 75% to 34% (p<0.001), respectively. In the remaining seven countries with data available for 2004-2011, significant declines in prevalence of advanced disease were observed in Nigeria, Swaziland, Uganda, Vietnam, and Zimbabwe. What are the implications for public health practice? Declines in the prevalence of advanced disease at ART enrollment over time in most countries are encouraging, but in 2015, approximately a third of new ART patients still initiated ART late. Adoption of World Health Organization-recommended “treat-all” guidelines and strategies to facilitate earlier HIV testing, and treatment are needed. These strategies would help reduce HIV-related mortality and HIV incidence.

Original languageEnglish (US)
Pages (from-to)558-563
Number of pages6
JournalMorbidity and Mortality Weekly Report
Volume66
Issue number21
DOIs
StatePublished - Jun 2 2017

ASJC Scopus subject areas

  • Epidemiology
  • Health(social science)
  • Health, Toxicology and Mutagenesis
  • Health Information Management

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    Auld, A. F., Shiraishi, R. W., Oboho, I., Ross, C., Bateganya, M., Pelletier, V., Dee, J., Francois, K., Duval, N., Antoine, M., Delcher, C., Desforges, G., Griswold, M., Domercant, J. W., Joseph, N., Deyde, V., Desir, Y., Van Onacker, J. D., Robin, E., ... Ellerbrock, T. V. (2017). Trends in prevalence of advanced HIV disease at antiretroviral therapy enrollment - 10 countries, 2004-2015. Morbidity and Mortality Weekly Report, 66(21), 558-563. https://doi.org/10.15585/mmwr.mm6621a3