AsianScientist (May 18, 2011) – China’s substantial efforts to scale up access to highly active antiretroviral therapy (HAART) over the past seven years has resulted in national treatment coverage increasing from almost zero to 63.4 percent, and HIV-related deaths decreasing by more than 60 percent.
The findings have been published in The Lancet Infectious Diseases, and are the first to report nationwide HIV treatment and mortality data for China.
“Given the size of the country, and the geographical spread of individuals with HIV… China’s treatment coverage is remarkable… but it is far from the goal of complete coverage of people who meet the treatment criteria,” explained lead author Dr. Fujie Zhang of the National Center for AIDS/STD Control and Prevention in Beijing.
By the end of 2009, 323,252 people were reported as having HIV in China, of whom 82,540 have been treated by the China National Free Antiretroviral Treatment Program (CNFATP). Launched seven years ago in 2002, it scaled-up HIV treatment, initially to detect and treat former plasma donors, followed by the rest of the country.
The researchers first identified adults with HIV who were eligible for HAART using data from the national HIV epidemiology and treatment databases.
The study also focused on specific groups in urgent need of treatment. For injecting drug users, 42.7 percent received coverage with 15.9 deaths per 100 person-years; for those infected sexually, 61.7 percent received coverage with 17.5 deaths per 100 person-years. The best outcome was achieved with those infected through plasma donation or blood transfusion, with 80.2 percent coverage and only 6.7 deaths per 100 person-years.
The two strongest risk factors for HIV-related mortality were not receiving HAART and a low CD4 count when first declared eligible for treatment.
Despite the significance of this study, there remains an urgent need for a public health approach to antiretroviral regimens, disease monitoring, and follow-up services, say the study authors.
The study concluded that earlier diagnosis was required, and that treatment for injecting drug users, those infected sexually, and men should be increased. Migrants, the elderly, and minority groups are also still at a greater risk of not receiving treatment, the authors cautioned.
The article can be found at: Zhang F et al. (2011) Effect of earlier initiation of antiretroviral treatment and increased treatment coverage on HIV-related mortality in China: a national observational cohort study.
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Source: The Lancet.
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