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| Title |
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 |
| Author(s) |
Basia Zaba, Ivan Kasamba,Sian Floyd, et al - Personal Name
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Subject |
Epidemiology |
| Publisher |
Blackwell Publishing Ltd |
| Publishing Year |
2012 |
| Specific Detail Info |
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 ofARTneed 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 naı¨ve 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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