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Date of download: 6/23/2016 From: The Anticipated Clinical and Economic Effects of 90–90–90 in South Africa Ann Intern Med. Published online May 31, 2016.

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Presentation on theme: "Date of download: 6/23/2016 From: The Anticipated Clinical and Economic Effects of 90–90–90 in South Africa Ann Intern Med. Published online May 31, 2016."— Presentation transcript:

1 Date of download: 6/23/2016 From: The Anticipated Clinical and Economic Effects of 90–90–90 in South Africa Ann Intern Med. Published online May 31, 2016. doi:10.7326/M16-0799 Results of the HIV treatment cascade over time, by cascade strategy. For the current pace strategy, the literature-derived data and the model-projected effects on the current South African cascade after 1, 5, and 10 y of the current pace strategy are shown. At 10 y of the current pace strategy, 44% of living patients have virologic suppression. For the UNAIDS target strategy, model output demonstrates results that might be achieved in 5 and 10 y, compared with the 90–90–90 benchmark. When screening, linkage, and adherence and retention variables of the model were adjusted to force the 5-y values to reach 90–90–90 target values, 80% of patients who were alive and had virologic suppression in 10 y. The absolute number of patients alive in the 2 strategies over time differs owing to an increased number of transmissions and deaths in the current pace strategy. ART = antiretroviral therapy; UNAIDS = Joint United Nations Programme on HIV/AIDS. Figure Legend: Copyright © American College of Physicians. All rights reserved.American College of Physicians

2 Date of download: 6/23/2016 From: The Anticipated Clinical and Economic Effects of 90–90–90 in South Africa Ann Intern Med. Published online May 31, 2016. doi:10.7326/M16-0799 Survival outcomes over time, by cascade strategy. The difference in the height of the bars in each year indicates the cumulative number of additional transmissions in the current pace strategy compared with the UNAIDS target strategy. ART = antiretroviral therapy; UNAIDS = Joint United Nations Programme on HIV/AIDS. Figure Legend: Copyright © American College of Physicians. All rights reserved.American College of Physicians

3 Date of download: 6/23/2016 From: The Anticipated Clinical and Economic Effects of 90–90–90 in South Africa Ann Intern Med. Published online May 31, 2016. doi:10.7326/M16-0799 Cumulative HIV transmissions over the 10-year model horizon. By the end of 2025, the UNAIDS target strategy results in 2.051 million fewer transmission events. UNAIDS = Joint United Nations Programme on HIV/AIDS. Figure Legend: Copyright © American College of Physicians. All rights reserved.American College of Physicians

4 Date of download: 6/23/2016 From: The Anticipated Clinical and Economic Effects of 90–90–90 in South Africa Ann Intern Med. Published online May 31, 2016. doi:10.7326/M16-0799 Outcomes related to maternal orphans, by cascade strategy. “Maternal orphans” were defined as children younger than 18 years whose mother died of HIV/AIDS. Cumulative orphans are the cumulative number of children ever orphaned by HIV/AIDS during the time horizon of the analysis (see the Methods section). Current orphans are the projected number of orphans in a given year, accounting for both death among orphans after orphanhood and for aging out of being considered an orphan. The kinks in the solid lines around year 8 demonstrate the aging out of a large majority of prevalent orphans aged 9 to 14 y at model initiation. UNAIDS = Joint United Nations Programme on HIV/AIDS. Figure Legend: Copyright © American College of Physicians. All rights reserved.American College of Physicians

5 Date of download: 6/23/2016 From: The Anticipated Clinical and Economic Effects of 90–90–90 in South Africa Ann Intern Med. Published online May 31, 2016. doi:10.7326/M16-0799 Results of the HIV treatment cascade over time, by cascade strategy; sensitivity analysis of an alternative way of reaching virologic suppression goals for the UNAIDS target strategy. For the current pace strategy, the literature-derived data and the model-projected effects on the current South African cascade after 1, 5, and 10 y are shown. At 10 y of the current pace strategy, 44% of living patients have virologic suppression. For the UNAIDS target strategy, model output demonstrates results that might be achieved in 5 and 10 y, compared with the 90–90–90 benchmark. In the alternative UNAIDS target strategy, lower testing and linkage rates and higher rates of virologic suppression than in the UNAIDS target strategy base case were used to achieve viral suppression goals, but less than 81% of persons on ART. Although the UNAIDS target strategy and the alternative UNAIDS target strategy have similar viral suppression rates (~73% at 5 y), they differ in the proportion of persons receiving ART (81% and 75%, respectively). The number of patients alive in the 3 strategies over time differs owing to an increased number of transmissions and deaths. ART = antiretroviral therapy; UNAIDS = Joint United Nations Programme on HIV/AIDS. Figure Legend: Copyright © American College of Physicians. All rights reserved.American College of Physicians


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