Important note: Information in this article was accurate in 1999. The state of the art may have changed since the publication date.
New therapy explains the fall in AIDS incidence with a substantial rise in number of persons on treatment expected.
AIDS. 1999 Jan 14;13(1):103-8. Unique Identifier : AIDSLINE MED/99223958 Aalen OO; Farewell VT; De Angelis D; Day NE; Gill ON; Section of Medical Statistics, University of Oslo, Norway.
Abstract:
BACKGROUND: A marked decline in the number of reported AIDS cases has been observed in the United Kingdom, as in many industrialized countries, in 1996 and 1997. In England and Wales, a large reduction in AIDS cases has been recorded among homosexual and bisexual men. OBJECTIVES: To investigate, using data from the homosexuals and bisexuals in England and Wales as an example, possible explanations for the above decline such as the effects of new anti-retroviral therapies, or a decrease in the incidence of HIV in recent years. METHODS: A multistage model of HIV infection, HIV diagnosis, treatment and of AIDS diagnosis has been used to represent the pattern of HIV and AIDS incidence in homosexual and bisexual men in England and Wales up to the end of 1995. Scenarios for the post-1995 period were examined under different assumptions about changes in HIV incidence in recent years and treatment uptake and efficacy. RESULTS: The fall in the incidence of AIDS is unlikely to be the result of a reduction in HIV transmission during the 1990s. The most plausible explanation for this fall is the effect of new, more effective, anti-retroviral therapies. As a consequence, the number of individuals on treatment is likely to increase by 50 to 100% compared with the pre-1996 levels by the year 2001. Also, if the effect of the new therapies has a limited duration, or the use of such therapies is not well tolerated, the incidence of AIDS will rise again in the near future. CONCLUSIONS: These findings indicate that a substantial workload increase is under way for the healthcare system, and reiterate the need for measures to reduce HIV transmission as a means of bringing about a sustainable change in the incidence of AIDS.
Keywords: JOURNAL ARTICLE Acquired Immunodeficiency Syndrome/DIAGNOSIS/DRUG THERAPY/ *EPIDEMIOLOGY England/EPIDEMIOLOGY Female Human Incidence Male Models, Biological Predictive Value of Tests Wales/EPIDEMIOLOGY 990930
A9991364
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Important note: Information in this article was accurate in 1999. The state of the art may have changed since the publication date.
