| Titre : | Extent to which low-level use of antiretroviral treatment could curb the AIDS epidemic in sub-Saharan Africa. (2000) |
| Auteurs : | E. WOOD ; P. BRAITSTEIN ; R.S. HOGG ; J.S.G. MONTANER ; M.V. O'SHAUGHNESSY ; M.T. SCHECHTER ; M.W. TYNDALL ; British Columbia Centre for Excellence In Hiv. Aids. St Paul's Hospital. Vancouver. BC. CAN ; Department of Health Care and Epidemiology. University of British Columbia. Vancouver. CAN |
| Type de document : | Article |
| Dans : | Lancet (The) (vol. 355, n° 9221, 2000) |
| Pagination : | 2095-2100 |
| Langues: | Anglais |
| Mots-clés : | Sida ; Virose ; Infection ; VIH ; Rétrovirus ; Virus ; Epidémiologie ; Médicament antiviral ; Thérapeutique médicamenteuse ; Thérapeutique ; Pays voie développement ; Démographie ; Homme ; Afrique ; Immunopathologie |
| Résumé : | [BDSP. Notice produite par INIST pR0xm864. Diffusion soumise à autorisation]. Background Despite growing international pressure to provide HIV-1 treatment to less-developed countries, potential demographic and epidemiological impacts have yet to be characterised. We modelled the future impact of antiretroviral use in South Africa from 2000 to 2005. Methods We produced a population projection model that assumed zero antiretroviral use to estimate the future demographic impacts of the HIV-1 epidemic. We also constructed four antiretroviral-adjusted scenarios to estimate the potential effect of antiretroviral use. We modelled total drug cost, cost per life-year gained, and the proportion of per-person health-care expenditure required to finance antiretroviral treatment in each scenario. Findings With no antiretroviral use between 2000 and 2005, there will be about 276 000 cumulative HIV-1-positive births, 2 302 000 cumulative new AIDS cases, and the life expectancy at birth will be 46.6 years by 2005. By contrast, 110 000 HIV-1-positive births could be prevented by short-course antiretroviral prophylaxis, as well as a decline of up to 1 year of life expectancy. The direct drug costs of universal coverage for this intervention would be US$54 million-less than 0.001% of the per-person health-care expenditure. In comparison, triple-combination treatment for 25% of the HIV-1-positive population could prevent a 3.1-year decline in life expectancy and more than 430 000 incident AIDS cases. (...) |
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