Description:
Background: There has been tremendous scale-up of antiretroviral therapy (ART)
services in the Asia Pacific region, which is home to an estimated 4.7 million persons
living with HIV/AIDS. We examined treatment scale-up, ART program practices, and
clinical outcome data in the nine low-and-middle-income countries that share over
95% of the HIV burden in the region.
Methods: Standardized indicators for ART scale-up and treatment outcomes were
examined for Cambodia, China, India, Indonesia, Myanmar, Nepal, Papua New
Guinea, Thailand, and Vietnam using data submitted by each country to the WHO/
The Joint United Nations Programme on HIV/AIDS (UNAIDS)/UNICEF joint framework
tool for monitoring the health sector response to HIV/AIDS. Data on ART program
practices were abstracted from National HIV Treatment Guidelines for each country.
Results: At the end of 2009, over 700 000 HIV-infected persons were receiving ART in
the nine focus countries. Treatment coverage varies widely in the region, ranging from
16 to 93%. All nine countries employ a public health approach to ART services and
provide a standardized first-line nonnucleoside reverse transcriptase inhibitor-based
regimen. Among patients initiated on first-line ART in these countries, 65–88% remain
alive and on treatment 12 months later. Over 50% of mortality occurs in the first
6 months of therapy, and losses to follow-up range from 8 to 16% at 2 years.
Conclusion: Impressive ART scale-up efforts in the region have resulted in significant
improvements in survival among persons receiving therapy. Continued funding support
and political commitment will be essential for further expansion of public sector ART
services to those in need. To improve treatment outcomes, national programs should
focus on earlier identification of persons requiring ART, decentralization of ART
services, and the development of stronger healthcare systems to support the provision
of a continuum of HIV care....Keywords: antiretroviral therapy, Asia Pacific, HIV, outcomes, scale-up,
treatment
Source/publisher:
"AIDS" 2010, 24 (suppl 3):S62–S71
Date of Publication:
2010-00-00
Date of entry:
2010-10-26
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- Individual Documents
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Language:
English
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pdf
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