HIV Treatment as Prevention: Optimising the Impact of Expanded HIV Treatment Programmes
Citations
63 citations
Cites methods from "HIV Treatment as Prevention: Optimi..."
...We currently promote ART both in order to achieve maximum therapeutic benefits and for treatment as prevention [13]....
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48 citations
Cites background from "HIV Treatment as Prevention: Optimi..."
...have been proposals to increase ART eligibility, and, because limited resources constrain universal expansion, there have been suggestions for incremental expansion of eligibility, such as all pregnant women and discordant couples irrespective of CD4þ cell count, raising the CD4þ cell eligibility threshold to less than 500 cells/ml, or all persons with increased risk of HIV infection [6]....
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45 citations
43 citations
Cites background from "HIV Treatment as Prevention: Optimi..."
...The social acceptability and equity of prioritizing access to early ART to this population is questionable, though [37]....
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39 citations
Cites background from "HIV Treatment as Prevention: Optimi..."
...Research suggests that alternative policies such as universal testing and immediate treatment of all HIV-infected patients (UTT) [9] and targeting specific risk groups [10,11], would be more efficient than the present programme....
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...In addition, there is a growing interest in tailoring HIV treatment guidelines to most efficiently target programmes [10,11]....
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References
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"HIV Treatment as Prevention: Optimi..." refers background or methods in this paper
...The HPTN 052 study [4] demonstrated that earlier ART initiation can reduce heterosexual HIV transmission [5]....
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...Observational and clinical trial data that link transmission events confirm that heterosexual transmissions occur from asymptomatically infected individuals with CD4 counts between 350 and 500 cells/ml [5,11], and the HPTN 052 study demonstrated a 96% reduction in transmission associated with treatment initiation at a CD4 cell count between 350 and 550 cells/ml compared to delaying treatment until CD4 count was below 250 cells/ml [5]....
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...was associated with a 41% increased hazard of adverse clinical outcome [5]....
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...Trial and observational data have demonstrated the efficacy of ART in preventing HIV transmission in stable serodiscordant heterosexual partnerships [5,11], and recent WHO guidelines for stable serodiscordant couples already include offering ART to the HIV-infected partner irrespective of CD4 cell count, in addition to behaviour change counselling [69]....
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...7 per 100 person-years at risk ([5]; among those with CD4 counts of 350–500 cells/ml: [11])....
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