Estimates of global, regional, and national incidence, prevalence, and mortality of HIV, 1980–2015: the Global Burden of Disease Study 2015

Collaborators, Gbd Hiv and Wang, H. and Wolock, T. M. and Carter, A. and Nguyen, G. and Kyu, H. H. and Gakidou, E. and Hay, S. I. and Msemburi, W. and Coates, M. M. and Mooney, M. D. and Fraser, M. S. and Sligar, A. and Larson, H. J. and Friedman, J. and Brown, A. and Dandona, L. and Fullman, N. and Haagsma, J. and Khalil, I. and Lim, S. S. and Mikesell, J. and Mokdad, A. H. and Moradi-Lakeh, M. and Pearson, K. and Silpakit, N. and Sorensen, R. J. D. and Temesgen, A. M. and Vollset, S. E. and Zoeckler, L. and Murray, C. J. L. and Alfonso-Cristancho, R. and Harun, K. M. and Prokop, D. M. and Mills, E. J. and Trickey, A. and Ajala, O. N. and Bärnighausen, T. and Ding, E. L. and Farvid, M. S. and Thorne-Lyman, A. L. and Won, S. and Fitchett, J. R. A. and Salomon, J. and Abajobir, A. A. and Hoy, D. G. and Alam, N. K. M. and Abate, K. H. and Ghiwot, T. T. and Gebremedhin, A. T. and Abbas, K. M. and Abd El Razek, M. M. and Abd-Allah, F. and Abdulle, A. M. and Abera, S. F. and Melaku, Y. A. and Tesfay, F. H. and Abyu, G. Y. and Bayou, T. A. and Betsu, B. D. and Gebru, A. A. and Hailu, G. B. and Tekle, T. and Yalew, A. Z. and Yebyo, H. G. and Abubakar, I. and Aldridge, R. W. and Abu-Raddad, L. J. and Abu-Rmeileh, N. M. E. and Adebiyi, A. O. and Adedeji, I. A. and Adelekan, A. L. and Ojelabi, F. A. and Adofo, K. and Adou, A. K. and Akinyemiju, T. F. and Schwebel, D. C. and Singh, J. A. and Akseer, N. and Al Lami, F. H. and Al-Aly, Z. and Alam, K. and Weintraub, R. G. and Chiang, P. P. and Meretoja, A. and Lopez, A. D. and Wijeratne, T. and Driscoll, T. R. and Kemp, A. H. and Leigh, J. and Mekonnen, A. B. and Karema, C. K. and Alasfoor, D. and Aldhahri, S. F. S. and Terkawi, A. S. and Alegretti, M. A. and Aleman, A. V. and Alemu, Z. A. and Cooper, C. and Deribew, A. and others, (2016) Estimates of global, regional, and national incidence, prevalence, and mortality of HIV, 1980–2015: the Global Burden of Disease Study 2015. The Lancet HIV, 3 (8). e361-e387.

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Background Timely assessment of the burden of HIV/AIDS is essential for policy setting and programme evaluation. In this report from the Global Burden of Disease Study 2015 (GBD 2015), we provide national estimates of levels and trends of HIV/AIDS incidence, prevalence, coverage of antiretroviral therapy (ART), and mortality for 195 countries and territories from 1980 to 2015. Methods For countries without high-quality vital registration data, we estimated prevalence and incidence with data from antenatal care clinics and population-based seroprevalence surveys, and with assumptions by age and sex on initial CD4 distribution at infection, CD4 progression rates (probability of progression from higher to lower CD4 cell-count category), on and off antiretroviral therapy (ART) mortality, and mortality from all other causes. Our estimation strategy links the GBD 2015 assessment of all-cause mortality and estimation of incidence and prevalence so that for each draw from the uncertainty distribution all assumptions used in each step are internally consistent. We estimated incidence, prevalence, and death with GBD versions of the Estimation and Projection Package (EPP) and Spectrum software originally developed by the Joint United Nations Programme on HIV/AIDS (UNAIDS). We used an open-source version of EPP and recoded Spectrum for speed, and used updated assumptions from systematic reviews of the literature and GBD demographic data. For countries with high-quality vital registration data, we developed the cohort incidence bias adjustment model to estimate HIV incidence and prevalence largely from the number of deaths caused by HIV recorded in cause-of-death statistics. We corrected these statistics for garbage coding and HIV misclassification. Findings Global HIV incidence reached its peak in 1997, at 3·3 million new infections (95 uncertainty interval UI 3·1–3·4 million). Annual incidence has stayed relatively constant at about 2·6 million per year (range 2·5–2·8 million) since 2005, after a period of fast decline between 1997 and 2005. The number of people living with HIV/AIDS has been steadily increasing and reached 38·8 million (95% UI 37·6–40·4 million) in 2015. At the same time, HIV/AIDS mortality has been declining at a steady pace, from a peak of 1·8 million deaths (95% UI 1·7–1·9 million) in 2005, to 1·2 million deaths (1·1–1·3 million) in 2015. We recorded substantial heterogeneity in the levels and trends of HIV/AIDS across countries. Although many countries have experienced decreases in HIV/AIDS mortality and in annual new infections, other countries have had slowdowns or increases in rates of change in annual new infections. Interpretation Scale-up of ART and prevention of mother-to-child transmission has been one of the great successes of global health in the past two decades. However, in the past decade, progress in reducing new infections has been slow, development assistance for health devoted to HIV has stagnated, and resources for health in low-income countries have grown slowly. Achievement of the new ambitious goals for HIV enshrined in Sustainable Development Goal 3 and the 90-90-90 UNAIDS targets will be challenging, and will need continued efforts from governments and international agencies in the next 15 years to end AIDS by 2030. Funding Bill & Melinda Gates Foundation, and National Institute of Mental Health and National Institute on Aging, National Institutes of Health. © 2016 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license

Item Type: Article
Additional Information: Cited By :272 Export Date: 16 February 2020
Uncontrolled Keywords: acquired immune deficiency syndrome Article CD4 lymphocyte count cell heterogeneity death health care survey highly active antiretroviral therapy human Human immunodeficiency virus infection Human immunodeficiency virus prevalence mortality rate priority journal sexually transmitted disease virus transmission global disease burden global health HIV Infections incidence mortality prevalence seroepidemiology statistics and numerical data time factor transmission virology young adult Antiretroviral Therapy, Highly Active Global Burden of Disease Humans Seroepidemiologic Studies Time Factors
Subjects: WC Communicable Diseases
Divisions: Mashhad University of Medical Sciences
Depositing User: mr lib4 lib4
Date Deposited: 03 Mar 2020 05:38
Last Modified: 03 Mar 2020 05:38

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