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Treatment 2013 Overview – Current global situation Tsitsi Apollo Zimbabwe
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9.7 million people on ART by end of 2012 -
1.6 million more than at the end of 2011 Actual and projected numbers of people receiving antiretroviral therapy in low-and middle-income countries, and by WHO Region, 2003–2015 Source: 2013 Global AIDS Response Progress Reporting (WHO/UNICEF/UNAIDS).
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People on ART: Progress in all Regions, global increase sustained by high population growth rate in Sub-Saharan Africa 25 100 Absolute number of people on ART at end of 2012 + Absolute increase in 2012 Source: 2013 Global AIDS Response Progress Reporting (WHO/UNICEF/UNAIDS).
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630 000 children globally on ART
8 500 + 300 12 000 1 100 + 100 46 100 19 100 Absolute number of children < 15 years on ART at end of 2012 Source: 2013 Global AIDS Response Progress Reporting (WHO/UNICEF/UNAIDS).
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The gap between adult and child ART coverage in 20 high burden countries is widening
Source: Global AIDS Response Progress Reporting (WHO/UNICEF/UNAIDS) and 2013 UNAIDS estimates.
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PMTCT coverage in “Global Plan countries” increases from
PMTCT coverage in “Global Plan countries” increases from % to 65% ( ) Note: Numbers from 2009 include single-dose nevirapine. Numbers from exclude single-dose nevirapine. Source: 2013 Global AIDS Response Reporting (WHO/UNICEF/UNAIDS) and 2012 UNAIDS/WHO estimates.
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ART averted 4.2 million deaths in past decade
Annual number of people dying from AIDS-related causes in low- and middle-income countries globally compared with a scenario of no antiretroviral therapy, 1996–2012 a The data points for 2012 are projected based on the scaling up of programmes in 2009–2011 and do not represent official estimates of the number of annual AIDS-related deaths.
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PMTCT averted more than 800 000 child infections in past decade
Number of children acquiring HIV infection in low- and middle-income countries, 1996–2012 a The data points for 2012 are projected based on the scaling up of programmes in 2009–2011 and do not represent official estimates of the number of annual child infections.
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When to start – ART Trends
Estimated millions of people eligible for ART in lower & middle-income countries in 2012 CD4 ≤ 200 CD4 ≤ 350 + TB/HIV HBV/HIV CD4 ≤ 350 + TB/HIV HBV/HIV CD4 ≤ 500 “Test and treat” All HIV+ 1 2 3 4 5 + TB/HIV HBV/HIV SD couples Pregnant Children < 5 Recommended until 2010 Recent studies, along with an improved understanding of the chronic inflammation caused by HIV, point to the potential clinical benefits of starting ART at CD4+ count levels above 350 cells/mm3. Some countries have already adapted their national treatment guidelines accordingly. Changing the ART threshold from 350 to 500 cells/mm3 (in addition to including the groups mentioned above regardless of CD4+ levels), would further increase the pool of people eligible for ART to 26 million. Recommended since 2010 ART regardless of CD4 count for: HIV-SD couples Pregnant women
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New guidelines increase ART eligibility to up to
25.9 million people 9.7 million 16.2 million
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