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Elimination of AIDS Would Require Universal HIV Testing

Along with testing, prompt antiretroviral therapy can check disease transmission and mortality

WEDNESDAY, Nov. 26 (HealthDay News) -- In a severe generalized HIV/AIDS epidemic, universal voluntary HIV testing and prompt antiretroviral therapy can effectively control disease transmission and eventually eliminate the infection, according to an article published online Nov. 26 in The Lancet.

Reuben M. Granich, M.D., and colleagues at the World Health Organization in Geneva, Switzerland, used mathematical models to analyze data from individuals aged 15 and older in South Africa to investigate the impact of voluntary HIV testing and antiretroviral therapy strategies on the number of secondary infections resulting from a primary infection in a population susceptible to heterosexual transmission.

Compared with the strategy of starting antiretroviral therapy when CD4+ count is less than 350 cells per μL, the stochastic model indicated that annual testing of adolescents and adults followed by prompt institution of antiretroviral therapy among positive cases when their CD4+ count is greater than 900 cell per μL could reduce HIV incidence, prevalence and mortality by 55 percent by the year 2050, the report indicates. Such a strategy could be cost-effective in the long term, the researchers note.

"Although other prevention interventions, alone or in combination, could substantially reduce HIV incidence, our model suggests that only universal voluntary HIV testing and immediate initiation of antiretroviral therapy could reduce transmission to the point at which elimination might be feasible by 2020 for a generalized epidemic, such as that in South Africa," the authors write.

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