Growing challenges for HIV programmes in Asia: clinic population trends, 2003–2013

Nicole L. De La Mata, Nagalingeswaran Kumarasamy, Penh Sun Ly, Oon Tek Ng, Kinh Van Nguyen, Tuti Parwati Merati, Man Po Lee, Cuong Duy Do, Jun Yong Choi, Jeremy L. Ross, Matthew G. Law

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Abstract

The scale-up of antiretroviral therapy (ART) has led to a substantial change in the clinical population of HIV-positive patients receiving care. We describe the temporal trends in the demographic and clinical characteristics of HIV-positive patients initiating ART in 2003–13 within an Asian regional cohort. All HIV-positive adult patients that initiated ART between 2003 and 2013 were included. We summarized ART regimen use, age, CD4 cell count, HIV viral load, and HIV-related laboratory monitoring rates during follow-up by calendar year. A total of 16 962 patients were included in the analysis. Patients in active follow-up increased from 695 patients at four sites in 2003 to 11,137 patients at eight sites in 2013. The proportion of patients receiving their second or third ART regimen increased over time (5% in 2003 to 29% in 2013) along with patients aged ≥50 years (8% in 2003 to 18% in 2013). Concurrently, CD4 monitoring has remained stable in recent years, whereas HIV viral load monitoring, although varied among the sites, is increasing. There have been substantial changes in the clinical and demographic characteristics of HIV-positive patients receiving ART in Asia. HIV programmes will need to anticipate the clinical care needs for their aging populations, expanded viral load monitoring, and, the eventual increase in second and third ART regimens that will lead to higher costs and more complex drug procurement needs.

Original languageEnglish
Pages (from-to)1243-1254
Number of pages12
JournalAIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
Volume29
Issue number10
DOIs
Publication statusPublished - 2017 Oct 3

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All Science Journal Classification (ASJC) codes

  • Social Psychology
  • Health(social science)
  • Public Health, Environmental and Occupational Health

Cite this

De La Mata, N. L., Kumarasamy, N., Ly, P. S., Ng, O. T., Nguyen, K. V., Merati, T. P., Lee, M. P., Do, C. D., Choi, J. Y., Ross, J. L., & Law, M. G. (2017). Growing challenges for HIV programmes in Asia: clinic population trends, 2003–2013. AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV, 29(10), 1243-1254. https://doi.org/10.1080/09540121.2017.1282108