Skip to main content
Erschienen in: Current HIV/AIDS Reports 4/2014

01.12.2014 | Treatment as Prevention (RM Granich, Section Editor)

Modeling the Implementation of Universal Coverage for HIV Treatment as Prevention and its Impact on the HIV Epidemic

verfasst von: Roger Ying, Ruanne V. Barnabas, Brian G. Williams

Erschienen in: Current HIV/AIDS Reports | Ausgabe 4/2014

Einloggen, um Zugang zu erhalten

Abstract

The Joint United Nations Programme on HIV/AIDS (UNAIDS) recently updated its global targets for antiretroviral therapy (ART) coverage for HIV-positive persons under which 90 % of HIV-positive people are tested, 90 % of those are on ART, and 90 % of those achieve viral suppression. Treatment policy is moving toward treating all HIV-infected persons regardless of CD4 cell count—otherwise known as treatment as prevention—in order to realize the full therapeutic and preventive benefits of ART. Mathematical models have played an important role in guiding the development of these policies by projecting long-term health impacts and cost-effectiveness. To guide future policy, new mathematical models must consider the barriers patients face in receiving and taking ART. Here, we describe the HIV care cascade and ART delivery supply chain to examine how mathematical modeling can provide insight into cost-effective strategies for scaling-up ART coverage in sub-Saharan Africa and help achieve universal ART coverage.
Literatur
1.
Zurück zum Zitat Palmer S, Maldarelli F, Wiegand A, Bernstein B, Hanna GJ, Brun SC, et al. Low-level viremia persists for at least 7 years in patients on suppressive antiretroviral therapy. Proc Natl Acad Sci U S A. 2008;105:3879–84.PubMedCentralPubMedCrossRef Palmer S, Maldarelli F, Wiegand A, Bernstein B, Hanna GJ, Brun SC, et al. Low-level viremia persists for at least 7 years in patients on suppressive antiretroviral therapy. Proc Natl Acad Sci U S A. 2008;105:3879–84.PubMedCentralPubMedCrossRef
2.•
Zurück zum Zitat Cohen MS, Chen YQ, McCauley M, Gamble T, Hosseinipour MC, Kumarasamy N, et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011;365:493–505. This paper describes the results of the first randomized study of early ART treatment for preventing HIV transmission (HPTN 052) which demonstrated a 96% reduction in the risk of HIV transmission with early ART provision.PubMedCentralPubMedCrossRef Cohen MS, Chen YQ, McCauley M, Gamble T, Hosseinipour MC, Kumarasamy N, et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011;365:493–505. This paper describes the results of the first randomized study of early ART treatment for preventing HIV transmission (HPTN 052) which demonstrated a 96% reduction in the risk of HIV transmission with early ART provision.PubMedCentralPubMedCrossRef
3.
Zurück zum Zitat Delva W, Eaton JW, Meng F, Fraser C, White RG, Vickerman P, et al. HIV treatment as prevention: optimising the impact of expanded HIV treatment programmes. PLoS Med. 2012;9:e1001258.PubMedCentralPubMedCrossRef Delva W, Eaton JW, Meng F, Fraser C, White RG, Vickerman P, et al. HIV treatment as prevention: optimising the impact of expanded HIV treatment programmes. PLoS Med. 2012;9:e1001258.PubMedCentralPubMedCrossRef
4.
Zurück zum Zitat Sidibé M, Zuniga JM, Montaner J. Leveraging HIV treatment to end AIDS, stop new HIV infections, and avoid the cost of inaction. Clin Infect Dis. 2014;59 Suppl 1:S3–6.PubMedCentralPubMedCrossRef Sidibé M, Zuniga JM, Montaner J. Leveraging HIV treatment to end AIDS, stop new HIV infections, and avoid the cost of inaction. Clin Infect Dis. 2014;59 Suppl 1:S3–6.PubMedCentralPubMedCrossRef
5.
Zurück zum Zitat Tanser F, Bärnighausen T, Grapsa E, Zaidi J, Newell ML. High coverage of ART associated with decline in risk of HIV acquisition in rural KwaZulu-Natal, South Africa. Science. 2013;339:966–71.PubMedCentralPubMedCrossRef Tanser F, Bärnighausen T, Grapsa E, Zaidi J, Newell ML. High coverage of ART associated with decline in risk of HIV acquisition in rural KwaZulu-Natal, South Africa. Science. 2013;339:966–71.PubMedCentralPubMedCrossRef
6.
Zurück zum Zitat Montaner JS, Lima VD, Barrios R, Yip B, Wood E, Kerr T, et al. Association of highly active antiretroviral therapy coverage, population viral load, and yearly new HIV diagnoses in British Columbia, Canada: a population-based study. Lancet. 2010;376:532–9.PubMedCentralPubMedCrossRef Montaner JS, Lima VD, Barrios R, Yip B, Wood E, Kerr T, et al. Association of highly active antiretroviral therapy coverage, population viral load, and yearly new HIV diagnoses in British Columbia, Canada: a population-based study. Lancet. 2010;376:532–9.PubMedCentralPubMedCrossRef
7.
Zurück zum Zitat Das M, Chu PL, Santos GM, Scheer S, Vittinghoff E, McFarland W, et al. Decreases in community viral load are accompanied by reductions in new HIV infections in San Francisco. PLoS ONE. 2010;5:e11068.PubMedCentralPubMedCrossRef Das M, Chu PL, Santos GM, Scheer S, Vittinghoff E, McFarland W, et al. Decreases in community viral load are accompanied by reductions in new HIV infections in San Francisco. PLoS ONE. 2010;5:e11068.PubMedCentralPubMedCrossRef
8.••
Zurück zum Zitat Granich RM, Gilks CF, Dye C, De Cock KM, Williams BG. Universal voluntary HIV testing with immediate antiretroviral therapy as a strategy for elimination of HIV transmission: a mathematical model. Lancet. 2009;373:48–57. This mathematical modeling study is the first to suggest that HIV treatment as prevention can eliminate HIV transmission.PubMedCrossRef Granich RM, Gilks CF, Dye C, De Cock KM, Williams BG. Universal voluntary HIV testing with immediate antiretroviral therapy as a strategy for elimination of HIV transmission: a mathematical model. Lancet. 2009;373:48–57. This mathematical modeling study is the first to suggest that HIV treatment as prevention can eliminate HIV transmission.PubMedCrossRef
9.
Zurück zum Zitat Cremin I, Alsallaq R, Dybul M, Piot P, Garnett G, Hallett TB. The new role of antiretrovirals in combination HIV prevention: a mathematical modelling analysis. AIDS. 2013;27:447–58.PubMedCrossRef Cremin I, Alsallaq R, Dybul M, Piot P, Garnett G, Hallett TB. The new role of antiretrovirals in combination HIV prevention: a mathematical modelling analysis. AIDS. 2013;27:447–58.PubMedCrossRef
10.
Zurück zum Zitat Eaton JW, Johnson LF, Salomon JA, Bärnighausen T, Bendavid E, Bershteyn A, et al. HIV treatment as prevention: systematic comparison of mathematical models of the potential impact of antiretroviral therapy on HIV incidence in South Africa. PLoS Med. 2012;9:e1001245.PubMedCentralPubMedCrossRef Eaton JW, Johnson LF, Salomon JA, Bärnighausen T, Bendavid E, Bershteyn A, et al. HIV treatment as prevention: systematic comparison of mathematical models of the potential impact of antiretroviral therapy on HIV incidence in South Africa. PLoS Med. 2012;9:e1001245.PubMedCentralPubMedCrossRef
11.
Zurück zum Zitat Hayes R, Ayles H, Beyers N, Sabapathy K, Floyd S, Shanaube K, et al. HPTN 071 (PopART): rationale and design of a cluster-randomised trial of the population impact of an HIV combination prevention intervention including universal testing and treatment—a study protocol for a cluster randomised trial. Trials. 2014;15:57.PubMedCentralPubMedCrossRef Hayes R, Ayles H, Beyers N, Sabapathy K, Floyd S, Shanaube K, et al. HPTN 071 (PopART): rationale and design of a cluster-randomised trial of the population impact of an HIV combination prevention intervention including universal testing and treatment—a study protocol for a cluster randomised trial. Trials. 2014;15:57.PubMedCentralPubMedCrossRef
12.
Zurück zum Zitat Easterbrook PJ, Doherty MC, Perriëns JH, Barcarolo JL, Hirnschall GO. The role of mathematical modelling in the development of recommendations in the 2013 WHO consolidated antiretroviral therapy guidelines. AIDS. 2014;28 Suppl 1:S85–92.PubMedCrossRef Easterbrook PJ, Doherty MC, Perriëns JH, Barcarolo JL, Hirnschall GO. The role of mathematical modelling in the development of recommendations in the 2013 WHO consolidated antiretroviral therapy guidelines. AIDS. 2014;28 Suppl 1:S85–92.PubMedCrossRef
13.
Zurück zum Zitat Wilson DP. HIV treatment as prevention: natural experiments highlight limits of antiretroviral treatment as HIV prevention. PLoS Med. 2012;9:e1001231.PubMedCentralPubMedCrossRef Wilson DP. HIV treatment as prevention: natural experiments highlight limits of antiretroviral treatment as HIV prevention. PLoS Med. 2012;9:e1001231.PubMedCentralPubMedCrossRef
14.
Zurück zum Zitat Kilmarx PH, Mutasa-Apollo T. Patching a leaky pipe: the cascade of HIV care. Curr Opin HIV AIDS. 2013;8:59–64.PubMed Kilmarx PH, Mutasa-Apollo T. Patching a leaky pipe: the cascade of HIV care. Curr Opin HIV AIDS. 2013;8:59–64.PubMed
15.
16.
Zurück zum Zitat van Rooyen H, Barnabas RV, Baeten JM, Phakathi Z, Joseph P, Krows M, et al. High HIV testing uptake and linkage to care in a novel program of home-based HIV counseling and testing with facilitated referral in KwaZulu-Natal, South Africa. J Acquir Immune Defic Syndr. 2013;64:e1–8.PubMedCentralPubMedCrossRef van Rooyen H, Barnabas RV, Baeten JM, Phakathi Z, Joseph P, Krows M, et al. High HIV testing uptake and linkage to care in a novel program of home-based HIV counseling and testing with facilitated referral in KwaZulu-Natal, South Africa. J Acquir Immune Defic Syndr. 2013;64:e1–8.PubMedCentralPubMedCrossRef
17.
Zurück zum Zitat Sabapathy K, Van den Bergh R, Fidler S, Hayes R, Ford N. Uptake of home-based voluntary HIV testing in sub-Saharan Africa: a systematic review and meta-analysis. PLoS Med. 2012;9:e1001351.PubMedCentralPubMedCrossRef Sabapathy K, Van den Bergh R, Fidler S, Hayes R, Ford N. Uptake of home-based voluntary HIV testing in sub-Saharan Africa: a systematic review and meta-analysis. PLoS Med. 2012;9:e1001351.PubMedCentralPubMedCrossRef
18.
Zurück zum Zitat Chamie G, Kwarisiima D, Clark TD, Kabami J, Jain V, Geng E, et al. Uptake of community-based HIV testing during a multi-disease health campaign in rural Uganda. PLoS ONE. 2014;9:e84317.PubMedCentralPubMedCrossRef Chamie G, Kwarisiima D, Clark TD, Kabami J, Jain V, Geng E, et al. Uptake of community-based HIV testing during a multi-disease health campaign in rural Uganda. PLoS ONE. 2014;9:e84317.PubMedCentralPubMedCrossRef
19.•
Zurück zum Zitat Suthar AB, Ford N, Bachanas PJ, Wong VJ, Rajan JS, Saltzman AK, et al. Towards universal voluntary HIV testing and counselling: a systematic review and meta-analysis of community-based approaches. PLoS Med. 2013;10:e1001496. This review and meta-analysis summarizes various community-based modalities for increasing HIV testing and linkage to care.PubMedCentralPubMedCrossRef Suthar AB, Ford N, Bachanas PJ, Wong VJ, Rajan JS, Saltzman AK, et al. Towards universal voluntary HIV testing and counselling: a systematic review and meta-analysis of community-based approaches. PLoS Med. 2013;10:e1001496. This review and meta-analysis summarizes various community-based modalities for increasing HIV testing and linkage to care.PubMedCentralPubMedCrossRef
20.
Zurück zum Zitat Chamie G, Kwarisiima D, Clark TD, Kabami J, Jain V, Geng E, et al. Leveraging rapid community-based HIV testing campaigns for non-communicable diseases in rural Uganda. PLoS ONE. 2012;7:e43400.PubMedCentralPubMedCrossRef Chamie G, Kwarisiima D, Clark TD, Kabami J, Jain V, Geng E, et al. Leveraging rapid community-based HIV testing campaigns for non-communicable diseases in rural Uganda. PLoS ONE. 2012;7:e43400.PubMedCentralPubMedCrossRef
21.
Zurück zum Zitat Cohen MS, Smith MK, Muessig KE, Hallett TB, Powers KA, Kashuba AD. Antiretroviral treatment of HIV-1 prevents transmission of HIV-1: where do we go from here? Lancet. 2013;382:1515–24.PubMedCrossRef Cohen MS, Smith MK, Muessig KE, Hallett TB, Powers KA, Kashuba AD. Antiretroviral treatment of HIV-1 prevents transmission of HIV-1: where do we go from here? Lancet. 2013;382:1515–24.PubMedCrossRef
22.
Zurück zum Zitat Lima VD, Thirumurthy H, Kahn JG, Saavedra J, Cárceres CF, Whiteside A. Modeling scenarios for the end of AIDS. Clin Infect Dis. 2014;59 Suppl 1:S16–20.PubMedCrossRef Lima VD, Thirumurthy H, Kahn JG, Saavedra J, Cárceres CF, Whiteside A. Modeling scenarios for the end of AIDS. Clin Infect Dis. 2014;59 Suppl 1:S16–20.PubMedCrossRef
23.
Zurück zum Zitat El-Sadr WM, Philip NM, Justman J. Letting HIV transform academia—embracing implementation science. N Engl J Med. 2014;370:1679–81.PubMedCrossRef El-Sadr WM, Philip NM, Justman J. Letting HIV transform academia—embracing implementation science. N Engl J Med. 2014;370:1679–81.PubMedCrossRef
24.
Zurück zum Zitat Young B, Zuniga JM, Montaner J, Mayer KH. Controlling the HIV epidemic with antiretrovirals: moving from consensus to implementation. Clin Infect Dis. 2014;59 Suppl 1:S1–2.PubMedCrossRef Young B, Zuniga JM, Montaner J, Mayer KH. Controlling the HIV epidemic with antiretrovirals: moving from consensus to implementation. Clin Infect Dis. 2014;59 Suppl 1:S1–2.PubMedCrossRef
25.
Zurück zum Zitat Wilson D, Fraser N. Who pays and why? Costs, effectiveness, and feasibility of HIV treatment as prevention. Clin Infect Dis. 2014;59 Suppl 1:S28–31.PubMedCrossRef Wilson D, Fraser N. Who pays and why? Costs, effectiveness, and feasibility of HIV treatment as prevention. Clin Infect Dis. 2014;59 Suppl 1:S28–31.PubMedCrossRef
26.
Zurück zum Zitat McNairy ML, El-Sadr WM. A paradigm shift: focus on the HIV prevention continuum. Clin Infect Dis. 2014;59 Suppl 1:S12–5.PubMedCrossRef McNairy ML, El-Sadr WM. A paradigm shift: focus on the HIV prevention continuum. Clin Infect Dis. 2014;59 Suppl 1:S12–5.PubMedCrossRef
27.
Zurück zum Zitat Nachega JB, Uthman OA, Del Rio C, Mugavero MJ, Rees H, Mills EJ. Addressing the Achilles’ heel in the HIV care continuum for the success of a test-and-treat strategy to achieve an AIDS-free generation. Clin Infect Dis. 2014;59 Suppl 1:S21–7.PubMedCrossRef Nachega JB, Uthman OA, Del Rio C, Mugavero MJ, Rees H, Mills EJ. Addressing the Achilles’ heel in the HIV care continuum for the success of a test-and-treat strategy to achieve an AIDS-free generation. Clin Infect Dis. 2014;59 Suppl 1:S21–7.PubMedCrossRef
28.
Zurück zum Zitat Granich R, Kahn JG, Bennett R, Holmes CB, Garg N, Serenata C, et al. Expanding ART for treatment and prevention of HIV in South Africa: estimated cost and cost-effectiveness 2011-2050. PLoS ONE. 2012;7:e30216.PubMedCentralPubMedCrossRef Granich R, Kahn JG, Bennett R, Holmes CB, Garg N, Serenata C, et al. Expanding ART for treatment and prevention of HIV in South Africa: estimated cost and cost-effectiveness 2011-2050. PLoS ONE. 2012;7:e30216.PubMedCentralPubMedCrossRef
29.
Zurück zum Zitat Walensky RP, Ross EL, Kumarasamy N, Wood R, Noubary F, Paltiel AD, et al. Cost-effectiveness of HIV treatment as prevention in serodiscordant couples. N Engl J Med. 2013;369:1715–25.PubMedCentralPubMedCrossRef Walensky RP, Ross EL, Kumarasamy N, Wood R, Noubary F, Paltiel AD, et al. Cost-effectiveness of HIV treatment as prevention in serodiscordant couples. N Engl J Med. 2013;369:1715–25.PubMedCentralPubMedCrossRef
30.
Zurück zum Zitat Cori A, Ayles H, Beyers N, Schaap A, Floyd S, Sabapathy K, et al. HPTN 071 (PopART): a cluster-randomized trial of the population impact of an HIV combination prevention intervention including universal testing and treatment: mathematical model. PLoS ONE. 2014;9:e84511.PubMedCentralPubMedCrossRef Cori A, Ayles H, Beyers N, Schaap A, Floyd S, Sabapathy K, et al. HPTN 071 (PopART): a cluster-randomized trial of the population impact of an HIV combination prevention intervention including universal testing and treatment: mathematical model. PLoS ONE. 2014;9:e84511.PubMedCentralPubMedCrossRef
31.
Zurück zum Zitat Granich R, Gupta S, Suthar AB, Smyth C, Hoos D, Vitoria M, et al. Antiretroviral therapy in prevention of HIV and TB: update on current research efforts. Curr HIV Res. 2011;9:446–69.PubMedCentralPubMedCrossRef Granich R, Gupta S, Suthar AB, Smyth C, Hoos D, Vitoria M, et al. Antiretroviral therapy in prevention of HIV and TB: update on current research efforts. Curr HIV Res. 2011;9:446–69.PubMedCentralPubMedCrossRef
32.
Zurück zum Zitat Eaton JW, Menzies NA, Stover J, Cambiano V, Chindelevitch L, Cori A, et al. Health benefits, costs, and cost-effectiveness of earlier eligibility for adult antiretroviral therapy and expanded treatment coverage: a combined analysis of 12 mathematical models. Lancet Glob Health. 2013;2:23–34.PubMedCentralPubMedCrossRef Eaton JW, Menzies NA, Stover J, Cambiano V, Chindelevitch L, Cori A, et al. Health benefits, costs, and cost-effectiveness of earlier eligibility for adult antiretroviral therapy and expanded treatment coverage: a combined analysis of 12 mathematical models. Lancet Glob Health. 2013;2:23–34.PubMedCentralPubMedCrossRef
33.
Zurück zum Zitat Bailey RC, Moses S, Parker CB, Agot K, Maclean I, Krieger JN, et al. Male circumcision for HIV prevention in young men in Kisumu, Kenya: a randomised controlled trial. Lancet. 2007;369:643–56.PubMedCrossRef Bailey RC, Moses S, Parker CB, Agot K, Maclean I, Krieger JN, et al. Male circumcision for HIV prevention in young men in Kisumu, Kenya: a randomised controlled trial. Lancet. 2007;369:643–56.PubMedCrossRef
34.
Zurück zum Zitat Baeten JM, Donnell D, Ndase P, Mugo NR, Campbell JD, Wangisi J, et al. Antiretroviral prophylaxis for HIV prevention in heterosexual men and women. N Engl J Med. 2012;367:399–410.PubMedCentralPubMedCrossRef Baeten JM, Donnell D, Ndase P, Mugo NR, Campbell JD, Wangisi J, et al. Antiretroviral prophylaxis for HIV prevention in heterosexual men and women. N Engl J Med. 2012;367:399–410.PubMedCentralPubMedCrossRef
35.
Zurück zum Zitat Abdool Karim Q, Abdool Karim SS, Frohlich JA, Grobler AC, Baxter C, Mansoor LE, et al. Effectiveness and safety of tenofovir gel, an antiretroviral microbicide, for the prevention of HIV infection in women. Science. 2010;329:1168–74.PubMedCentralPubMedCrossRef Abdool Karim Q, Abdool Karim SS, Frohlich JA, Grobler AC, Baxter C, Mansoor LE, et al. Effectiveness and safety of tenofovir gel, an antiretroviral microbicide, for the prevention of HIV infection in women. Science. 2010;329:1168–74.PubMedCentralPubMedCrossRef
36.
Zurück zum Zitat Alsallaq RA, Baeten JM, Celum CL, Hughes JP, Abu-Raddad LJ, Barnabas RV, et al. Understanding the potential impact of a combination HIV prevention intervention in a hyper-endemic community. PLoS ONE. 2013;8:e54575.PubMedCentralPubMedCrossRef Alsallaq RA, Baeten JM, Celum CL, Hughes JP, Abu-Raddad LJ, Barnabas RV, et al. Understanding the potential impact of a combination HIV prevention intervention in a hyper-endemic community. PLoS ONE. 2013;8:e54575.PubMedCentralPubMedCrossRef
37.
Zurück zum Zitat Kates J, Wexler A, Lief E. Financing the response to HIV in low- and middle-income countries: international assistance from donor governments in 2013. Kaiser Family Foundation; 2014. Kates J, Wexler A, Lief E. Financing the response to HIV in low- and middle-income countries: international assistance from donor governments in 2013. Kaiser Family Foundation; 2014.
38.
Zurück zum Zitat Facility-based unit costing for antiretroviral treatment in five Sub-Saharan African countries. The Clinton Health Access Initiative; 2011. Facility-based unit costing for antiretroviral treatment in five Sub-Saharan African countries. The Clinton Health Access Initiative; 2011.
39.
Zurück zum Zitat National AIDS and STI Control Programme (NASCOP), Kenya. Kenya AIDS indicator survey 2012: final report. Nairobi: NASCOP; 2014. National AIDS and STI Control Programme (NASCOP), Kenya. Kenya AIDS indicator survey 2012: final report. Nairobi: NASCOP; 2014.
40.
Zurück zum Zitat Shisana O, Rehle T, Simbayi L, Parker W, Jooste S, van Wyk VP, et al. South African national HIV prevalence, incidence, behavior and communication survey 2008: a turning tide among teenagers? Cape Town, South Africa; 2008. Shisana O, Rehle T, Simbayi L, Parker W, Jooste S, van Wyk VP, et al. South African national HIV prevalence, incidence, behavior and communication survey 2008: a turning tide among teenagers? Cape Town, South Africa; 2008.
41.
Zurück zum Zitat Shisana O, Rehle T, Simbayi L, Zuma K, Jooste S, Zungu N, et al. South African national HIV prevalence, incidence and behaviour survey, 2012. Cape Town; 2014. Shisana O, Rehle T, Simbayi L, Zuma K, Jooste S, Zungu N, et al. South African national HIV prevalence, incidence and behaviour survey, 2012. Cape Town; 2014.
42.
Zurück zum Zitat Lugada E, Millar D, Haskew J, Grabowsky M, Garg N, Vestergaard M, et al. Rapid implementation of an integrated large-scale HIV counseling and testing, malaria, and diarrhea prevention campaign in rural Kenya. PLoS ONE. 2010;5:e12435.PubMedCentralPubMedCrossRef Lugada E, Millar D, Haskew J, Grabowsky M, Garg N, Vestergaard M, et al. Rapid implementation of an integrated large-scale HIV counseling and testing, malaria, and diarrhea prevention campaign in rural Kenya. PLoS ONE. 2010;5:e12435.PubMedCentralPubMedCrossRef
43.
Zurück zum Zitat Lazarus JV, Safreed-Harmon K, Nicholson J, Jaffar S. Health service delivery models for the provision of antiretroviral therapy in sub-Saharan Africa: a systematic review. Trop Med Int Health. 2014. Lazarus JV, Safreed-Harmon K, Nicholson J, Jaffar S. Health service delivery models for the provision of antiretroviral therapy in sub-Saharan Africa: a systematic review. Trop Med Int Health. 2014.
44.
Zurück zum Zitat Rosenberg NE, Pettifor AE, De Bruyn G, Westreich D, Delany-Moretlwe S, Behets F, et al. HIV testing and counseling leads to immediate consistent condom use among South African stable HIV-discordant couples. J Acquir Immune Defic Syndr. 2013;62:226–33.PubMedCentralPubMedCrossRef Rosenberg NE, Pettifor AE, De Bruyn G, Westreich D, Delany-Moretlwe S, Behets F, et al. HIV testing and counseling leads to immediate consistent condom use among South African stable HIV-discordant couples. J Acquir Immune Defic Syndr. 2013;62:226–33.PubMedCentralPubMedCrossRef
45.
Zurück zum Zitat Montgomery ET, van der Straten A, Chidanyika A, Chipato T, Jaffar S, Padian N. The importance of male partner involvement for women’s acceptability and adherence to female-initiated HIV prevention methods in Zimbabwe. AIDS Behav. 2011;15:959–69.PubMedCentralPubMedCrossRef Montgomery ET, van der Straten A, Chidanyika A, Chipato T, Jaffar S, Padian N. The importance of male partner involvement for women’s acceptability and adherence to female-initiated HIV prevention methods in Zimbabwe. AIDS Behav. 2011;15:959–69.PubMedCentralPubMedCrossRef
46.
Zurück zum Zitat Barnabas R, Ying R, van Rooyen H, Murnane P, Hughes J, Baeten J, et al. Use of HIV viral-load suppression to estimate the effect of community-wide home-based HIV counselling and testing and linkage to antiretroviral therapy on HIV incidence in South Africa: a mathematical modelling analysis. Lancet. 2013;382(Supplement 2):S6.CrossRef Barnabas R, Ying R, van Rooyen H, Murnane P, Hughes J, Baeten J, et al. Use of HIV viral-load suppression to estimate the effect of community-wide home-based HIV counselling and testing and linkage to antiretroviral therapy on HIV incidence in South Africa: a mathematical modelling analysis. Lancet. 2013;382(Supplement 2):S6.CrossRef
47.
Zurück zum Zitat Dodd PJ, Garnett GP, Hallett TB. Examining the promise of HIV elimination by ‘test and treat’ in hyperendemic settings. AIDS. 2010;24:729–35.PubMedCentralPubMedCrossRef Dodd PJ, Garnett GP, Hallett TB. Examining the promise of HIV elimination by ‘test and treat’ in hyperendemic settings. AIDS. 2010;24:729–35.PubMedCentralPubMedCrossRef
48.•
Zurück zum Zitat Birger RB, Hallett TB, Sinha A, Grenfell BT, Hodder SL. Modeling the impact of interventions along the HIV continuum of care in Newark, New Jersey. Clin Infect Dis. 2013. This mathematical model simulates the HIV care cascade in Newark, New Jersey, and is one of the first models to critically assess specific steps in the care cascade. Birger RB, Hallett TB, Sinha A, Grenfell BT, Hodder SL. Modeling the impact of interventions along the HIV continuum of care in Newark, New Jersey. Clin Infect Dis. 2013. This mathematical model simulates the HIV care cascade in Newark, New Jersey, and is one of the first models to critically assess specific steps in the care cascade.
49.
Zurück zum Zitat Katz IT, Essien T, Marinda ET, Gray GE, Bangsberg DR, Martinson NA, et al. Antiretroviral therapy refusal among newly diagnosed HIV-infected adults. AIDS. 2011;25:2177–81.PubMedCentralPubMedCrossRef Katz IT, Essien T, Marinda ET, Gray GE, Bangsberg DR, Martinson NA, et al. Antiretroviral therapy refusal among newly diagnosed HIV-infected adults. AIDS. 2011;25:2177–81.PubMedCentralPubMedCrossRef
50.
Zurück zum Zitat Bassett IV, Regan S, Chetty S, Giddy J, Uhler LM, Holst H, et al. Who starts antiretroviral therapy in Durban, South Africa?… not everyone who should. AIDS. 2010;24 Suppl 1:S37–44.PubMedCentralPubMedCrossRef Bassett IV, Regan S, Chetty S, Giddy J, Uhler LM, Holst H, et al. Who starts antiretroviral therapy in Durban, South Africa?… not everyone who should. AIDS. 2010;24 Suppl 1:S37–44.PubMedCentralPubMedCrossRef
51.
Zurück zum Zitat Fox MP, Rosen S. Patient retention in antiretroviral therapy programs up to three years on treatment in sub-Saharan Africa, 2007–2009: systematic review. Trop Med Int Health. 2010;15 Suppl 1:1–15.PubMedCentralPubMedCrossRef Fox MP, Rosen S. Patient retention in antiretroviral therapy programs up to three years on treatment in sub-Saharan Africa, 2007–2009: systematic review. Trop Med Int Health. 2010;15 Suppl 1:1–15.PubMedCentralPubMedCrossRef
52.
Zurück zum Zitat Geng EH, Bangsberg DR, Musinguzi N, Emenyonu N, Bwana MB, Yiannoutsos CT, et al. Understanding reasons for and outcomes of patients lost to follow-up in antiretroviral therapy programs in Africa through a sampling-based approach. J Acquir Immune Defic Syndr. 2010;53:405–11.PubMedCentralPubMedCrossRef Geng EH, Bangsberg DR, Musinguzi N, Emenyonu N, Bwana MB, Yiannoutsos CT, et al. Understanding reasons for and outcomes of patients lost to follow-up in antiretroviral therapy programs in Africa through a sampling-based approach. J Acquir Immune Defic Syndr. 2010;53:405–11.PubMedCentralPubMedCrossRef
53.
Zurück zum Zitat Yu JK, Chen SC, Wang KY, Chang CS, Makombe SD, Schouten EJ, et al. True outcomes for patients on antiretroviral therapy who are “lost to follow-up” in Malawi. Bull World Health Organ. 2007;85:550–4.PubMedCentralPubMedCrossRef Yu JK, Chen SC, Wang KY, Chang CS, Makombe SD, Schouten EJ, et al. True outcomes for patients on antiretroviral therapy who are “lost to follow-up” in Malawi. Bull World Health Organ. 2007;85:550–4.PubMedCentralPubMedCrossRef
54.
Zurück zum Zitat Rosen S, Ketlhapile M. Cost of using a patient tracer to reduce loss to follow-up and ascertain patient status in a large antiretroviral therapy program in Johannesburg, South Africa. Trop Med Int Health. 2010;15 Suppl 1:98–104.PubMedCentralPubMedCrossRef Rosen S, Ketlhapile M. Cost of using a patient tracer to reduce loss to follow-up and ascertain patient status in a large antiretroviral therapy program in Johannesburg, South Africa. Trop Med Int Health. 2010;15 Suppl 1:98–104.PubMedCentralPubMedCrossRef
55.
Zurück zum Zitat Rich ML, Miller AC, Niyigena P, Franke MF, Niyonzima JB, Socci A, et al. Excellent clinical outcomes and high retention in care among adults in a community-based HIV treatment program in rural Rwanda. J Acquir Immune Defic Syndr. 2012;59:e35–42.PubMedCrossRef Rich ML, Miller AC, Niyigena P, Franke MF, Niyonzima JB, Socci A, et al. Excellent clinical outcomes and high retention in care among adults in a community-based HIV treatment program in rural Rwanda. J Acquir Immune Defic Syndr. 2012;59:e35–42.PubMedCrossRef
56.
Zurück zum Zitat Montaner JS, Lima VD, Harrigan PR, Lourenço L, Yip B, Nosyk B, et al. Expansion of HAART coverage is associated with sustained decreases in HIV/AIDS morbidity, mortality and HIV transmission: the “HIV treatment as prevention” experience in a Canadian setting. PLoS ONE. 2014;9:e87872.PubMedCentralPubMedCrossRef Montaner JS, Lima VD, Harrigan PR, Lourenço L, Yip B, Nosyk B, et al. Expansion of HAART coverage is associated with sustained decreases in HIV/AIDS morbidity, mortality and HIV transmission: the “HIV treatment as prevention” experience in a Canadian setting. PLoS ONE. 2014;9:e87872.PubMedCentralPubMedCrossRef
57.
Zurück zum Zitat Nosyk B, Montaner JS, Colley G, Lima VD, Chan K, Heath K, et al. The cascade of HIV care in British Columbia, Canada, 1996–2011: a population-based retrospective cohort study. Lancet Infect Dis. 2014;14:40–9.PubMedCentralPubMedCrossRef Nosyk B, Montaner JS, Colley G, Lima VD, Chan K, Heath K, et al. The cascade of HIV care in British Columbia, Canada, 1996–2011: a population-based retrospective cohort study. Lancet Infect Dis. 2014;14:40–9.PubMedCentralPubMedCrossRef
58.
Zurück zum Zitat Estill J, Tweya H, Egger M, Wandeler G, Feldacker C, Johnson LF, et al. Tracing of patients lost to follow-up and HIV transmission: mathematical modeling study based on 2 large ART programs in Malawi. J Acquir Immune Defic Syndr. 2014;65:e179–86.PubMedCrossRef Estill J, Tweya H, Egger M, Wandeler G, Feldacker C, Johnson LF, et al. Tracing of patients lost to follow-up and HIV transmission: mathematical modeling study based on 2 large ART programs in Malawi. J Acquir Immune Defic Syndr. 2014;65:e179–86.PubMedCrossRef
59.
Zurück zum Zitat Klein DJ, Bershteyn A, Eckhoff PA. Dropout and re-enrollment: implications for epidemiological projections of treatment programs. AIDS. 2014;28 Suppl 1:S47–59.PubMedCrossRef Klein DJ, Bershteyn A, Eckhoff PA. Dropout and re-enrollment: implications for epidemiological projections of treatment programs. AIDS. 2014;28 Suppl 1:S47–59.PubMedCrossRef
60.
Zurück zum Zitat Hoffmann CJ, Lewis JJ, Dowdy DW, Fielding KL, Grant AD, Martinson NA, et al. Mortality associated with delays between clinic entry and ART initiation in resource-limited settings: results of a transition-state model. J Acquir Immune Defic Syndr. 2013;63:105–11.PubMedCentralPubMedCrossRef Hoffmann CJ, Lewis JJ, Dowdy DW, Fielding KL, Grant AD, Martinson NA, et al. Mortality associated with delays between clinic entry and ART initiation in resource-limited settings: results of a transition-state model. J Acquir Immune Defic Syndr. 2013;63:105–11.PubMedCentralPubMedCrossRef
61.
Zurück zum Zitat Hallett TB, Eaton JW. A side door into care cascade for HIV-infected patients? J Acquir Immune Defic Syndr. 2013;63 Suppl 2:S228–32.PubMedCrossRef Hallett TB, Eaton JW. A side door into care cascade for HIV-infected patients? J Acquir Immune Defic Syndr. 2013;63 Suppl 2:S228–32.PubMedCrossRef
62.
Zurück zum Zitat UNAIDS/WHO. Global report: UNAIDS report on the global AIDS epidemic, 2013. Joint United Nations Programme on HIV/AIDS; 2013. UNAIDS/WHO. Global report: UNAIDS report on the global AIDS epidemic, 2013. Joint United Nations Programme on HIV/AIDS; 2013.
63.
Zurück zum Zitat Tolle MA, Phelps BR, Desmond C, Sugandhi N, Omeogu C, Jamieson D, et al. Delivering pediatric HIV care in resource-limited settings: cost considerations in an expanded response. AIDS. 2013;27 Suppl 2:S179–86.PubMedCrossRef Tolle MA, Phelps BR, Desmond C, Sugandhi N, Omeogu C, Jamieson D, et al. Delivering pediatric HIV care in resource-limited settings: cost considerations in an expanded response. AIDS. 2013;27 Suppl 2:S179–86.PubMedCrossRef
64.
Zurück zum Zitat Okoronkwo I, Okeke U, Chinweuba A, Iheanacho P. Nonadherence factors and sociodemographic characteristics of HIV-infected adults receiving antiretroviral therapy in Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria. ISRN AIDS. 2013;2013:843794.PubMedCentralPubMedCrossRef Okoronkwo I, Okeke U, Chinweuba A, Iheanacho P. Nonadherence factors and sociodemographic characteristics of HIV-infected adults receiving antiretroviral therapy in Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria. ISRN AIDS. 2013;2013:843794.PubMedCentralPubMedCrossRef
65.•
Zurück zum Zitat Kraiselburd S, Yadav P. Supply chains and global health: an imperative for bringing operations management scholarship into action, production and operations management. Production and operations management; 2013. pp. 377–381. This paper discusses the importance of supply chains in delivering critical medications in global health, as well as current supply chain weaknesses. Kraiselburd S, Yadav P. Supply chains and global health: an imperative for bringing operations management scholarship into action, production and operations management. Production and operations management; 2013. pp. 377–381. This paper discusses the importance of supply chains in delivering critical medications in global health, as well as current supply chain weaknesses.
66.
Zurück zum Zitat Ambitious treatment targets: writing the final chapter of the AIDS epidemic. Geneva: UNAIDS; 2014. Ambitious treatment targets: writing the final chapter of the AIDS epidemic. Geneva: UNAIDS; 2014.
67.
Zurück zum Zitat Fernandez M. Improving access to critical medicines: the last mile. HIV treatment as prevention workshop. Vancouver; 2014. Fernandez M. Improving access to critical medicines: the last mile. HIV treatment as prevention workshop. Vancouver; 2014.
68.
Zurück zum Zitat Trochim WM, Cabrera DA, Milstein B, Gallagher RS, Leischow SJ. Practical challenges of systems thinking and modeling in public health. Am J Public Health. 2006;96:538–46.PubMedCentralPubMedCrossRef Trochim WM, Cabrera DA, Milstein B, Gallagher RS, Leischow SJ. Practical challenges of systems thinking and modeling in public health. Am J Public Health. 2006;96:538–46.PubMedCentralPubMedCrossRef
70.
Zurück zum Zitat Bill & Melinda Gates Foundation. Oral PrEP in South Africa. Bottom-up cost model. Bill & Melinda Gates Foundation. Oral PrEP in South Africa. Bottom-up cost model.
71.
Zurück zum Zitat Rosen JE, Bancroft E, Hasselback L, Levin C, Mvundura M, Tien M. Last mile costs of public health supply chains in developing countries: recommendations for inclusion in the United Nations OneHealth Model. Arlington: USAID | DELIVER PROJECT, Task Order 4; 2012. Rosen JE, Bancroft E, Hasselback L, Levin C, Mvundura M, Tien M. Last mile costs of public health supply chains in developing countries: recommendations for inclusion in the United Nations OneHealth Model. Arlington: USAID | DELIVER PROJECT, Task Order 4; 2012.
72.••
Zurück zum Zitat Meyer-Rath G, Over M. HIV treatment as prevention: modelling the cost of antiretroviral treatment—state of the art and future directions. PLoS Med. 2012;9:e1001247. The authors explain the importance of including cost functions into mathematical models to provide more accurate estimates of the programmatic costs of ART provision.PubMedCentralPubMedCrossRef Meyer-Rath G, Over M. HIV treatment as prevention: modelling the cost of antiretroviral treatment—state of the art and future directions. PLoS Med. 2012;9:e1001247. The authors explain the importance of including cost functions into mathematical models to provide more accurate estimates of the programmatic costs of ART provision.PubMedCentralPubMedCrossRef
73.
Zurück zum Zitat Marseille E, Dandona L, Marshall N, Gaist P, Bautista-Arredondo S, Rollins B, et al. HIV prevention costs and program scale: data from the PANCEA project in five low and middle-income countries. BMC Health Serv Res. 2007;7:108.PubMedCentralPubMedCrossRef Marseille E, Dandona L, Marshall N, Gaist P, Bautista-Arredondo S, Rollins B, et al. HIV prevention costs and program scale: data from the PANCEA project in five low and middle-income countries. BMC Health Serv Res. 2007;7:108.PubMedCentralPubMedCrossRef
74.
Zurück zum Zitat Guinness L, Kumaranayake L, Rajaraman B, Sankaranarayanan G, Vannela G, Raghupathi P, et al. Does scale matter? The costs of HIV-prevention interventions for commercial sex workers in India. Bull World Health Organ. 2005;83:747–55.PubMedCentralPubMed Guinness L, Kumaranayake L, Rajaraman B, Sankaranarayanan G, Vannela G, Raghupathi P, et al. Does scale matter? The costs of HIV-prevention interventions for commercial sex workers in India. Bull World Health Organ. 2005;83:747–55.PubMedCentralPubMed
75.
76.
Zurück zum Zitat Brown ST, Schreiber B, Cakouros BE, Wateska AR, Dicko HM, Connor DL, et al. The benefits of redesigning Benin’s vaccine supply chain. Vaccine. 2014;32:4097–103.PubMedCrossRef Brown ST, Schreiber B, Cakouros BE, Wateska AR, Dicko HM, Connor DL, et al. The benefits of redesigning Benin’s vaccine supply chain. Vaccine. 2014;32:4097–103.PubMedCrossRef
77.
Zurück zum Zitat Assi TM, Brown ST, Kone S, Norman BA, Djibo A, Connor DL, et al. Removing the regional level from the Niger vaccine supply chain. Vaccine. 2013;31:2828–34.PubMedCentralPubMedCrossRef Assi TM, Brown ST, Kone S, Norman BA, Djibo A, Connor DL, et al. Removing the regional level from the Niger vaccine supply chain. Vaccine. 2013;31:2828–34.PubMedCentralPubMedCrossRef
78.
Zurück zum Zitat Futures Institute. OneHealthTool. 2011. Futures Institute. OneHealthTool. 2011.
79.
80.
Zurück zum Zitat Jamison DT, Summers LH, Alleyne G, Arrow KJ, Berkley S, Binagwaho A, et al. Global health 2035: a world converging within a generation. Lancet. 2013;382:1898–955.PubMedCrossRef Jamison DT, Summers LH, Alleyne G, Arrow KJ, Berkley S, Binagwaho A, et al. Global health 2035: a world converging within a generation. Lancet. 2013;382:1898–955.PubMedCrossRef
81.
Zurück zum Zitat Ekici A, Keskinocak P, Swann JL. Pandemic influenza response. Winter simulation conference. Miami, FL; 2008. Ekici A, Keskinocak P, Swann JL. Pandemic influenza response. Winter simulation conference. Miami, FL; 2008.
82.
Zurück zum Zitat Mvundura M, Kien VD, Nga NT, Robertson J, Cuong NV, Tung HT, et al. How much does it cost to get a dose of vaccine to the service delivery location? Empirical evidence from Vietnam’s Expanded Program on Immunization. Vaccine. 2014;32:834–8.PubMedCrossRef Mvundura M, Kien VD, Nga NT, Robertson J, Cuong NV, Tung HT, et al. How much does it cost to get a dose of vaccine to the service delivery location? Empirical evidence from Vietnam’s Expanded Program on Immunization. Vaccine. 2014;32:834–8.PubMedCrossRef
83.
Zurück zum Zitat McChord J, Tien M, Sarley D. Guide to public health supply chain costing: a basic methodology. Arlington: USAID | DELIVER PROJECT, Task Order 4; 2013. McChord J, Tien M, Sarley D. Guide to public health supply chain costing: a basic methodology. Arlington: USAID | DELIVER PROJECT, Task Order 4; 2013.
84.
Zurück zum Zitat Nkengasong JN, Nsubuga P, Nwanyanwu O, Gershy-Damet GM, Roscigno G, Bulterys M, et al. Laboratory systems and services are critical in global health: time to end the neglect? Am J Clin Pathol. 2010;134:368–73.PubMedCrossRef Nkengasong JN, Nsubuga P, Nwanyanwu O, Gershy-Damet GM, Roscigno G, Bulterys M, et al. Laboratory systems and services are critical in global health: time to end the neglect? Am J Clin Pathol. 2010;134:368–73.PubMedCrossRef
85.
Zurück zum Zitat Alemnji G, Fonjungo P, Van Der Pol B, Peter T, Kantor R, Nkengasong J. The centrality of laboratory services in the HIV treatment and prevention cascade: the need for effective linkages and referrals in resource-limited settings. AIDS Patient Care STDS. 2014;28:268–73.PubMedCrossRef Alemnji G, Fonjungo P, Van Der Pol B, Peter T, Kantor R, Nkengasong J. The centrality of laboratory services in the HIV treatment and prevention cascade: the need for effective linkages and referrals in resource-limited settings. AIDS Patient Care STDS. 2014;28:268–73.PubMedCrossRef
86.
Zurück zum Zitat Upfill-Brown AM, Lyons HM, Pate MA, Shuaib F, Baig S, Hu H, et al. Predictive spatial risk model of poliovirus to aid prioritization and hasten eradication in Nigeria. BMC Med. 2014;12:92.PubMedCentralPubMedCrossRef Upfill-Brown AM, Lyons HM, Pate MA, Shuaib F, Baig S, Hu H, et al. Predictive spatial risk model of poliovirus to aid prioritization and hasten eradication in Nigeria. BMC Med. 2014;12:92.PubMedCentralPubMedCrossRef
87.
Zurück zum Zitat Anderson SJ, Cherutich P, Kilonzo N, Cremin I, Fecht D, Kimanga D, et al. Maximising the effect of combination HIV prevention through prioritisation of the people and places in greatest need: a modelling study. Lancet. 2014;384:249–56.PubMedCrossRef Anderson SJ, Cherutich P, Kilonzo N, Cremin I, Fecht D, Kimanga D, et al. Maximising the effect of combination HIV prevention through prioritisation of the people and places in greatest need: a modelling study. Lancet. 2014;384:249–56.PubMedCrossRef
88.
Zurück zum Zitat Lawn SD, Mwaba P, Bates M, Piatek A, Alexander H, Marais BJ, et al. Advances in tuberculosis diagnostics: the Xpert MTB/RIF assay and future prospects for a point-of-care test. Lancet Infect Dis. 2013;13:349–61.PubMedCrossRef Lawn SD, Mwaba P, Bates M, Piatek A, Alexander H, Marais BJ, et al. Advances in tuberculosis diagnostics: the Xpert MTB/RIF assay and future prospects for a point-of-care test. Lancet Infect Dis. 2013;13:349–61.PubMedCrossRef
89.
Zurück zum Zitat Reiser H. Making new drugs available to all. HIV treatment as prevention workshop. Vancouver, Canada; 2014. Reiser H. Making new drugs available to all. HIV treatment as prevention workshop. Vancouver, Canada; 2014.
90.
Zurück zum Zitat Huff-Rousselle M. The logical underpinnings and benefits of pooled pharmaceutical procurement: a pragmatic role for our public institutions? Soc Sci Med. 2012;75:1572–80.PubMedCrossRef Huff-Rousselle M. The logical underpinnings and benefits of pooled pharmaceutical procurement: a pragmatic role for our public institutions? Soc Sci Med. 2012;75:1572–80.PubMedCrossRef
91.
Zurück zum Zitat Levine R, Pickett J, Sekhri N, Yadav P. Demand forecasting for essential medical technologies. Am J Law Med. 2008;34:225–55.PubMed Levine R, Pickett J, Sekhri N, Yadav P. Demand forecasting for essential medical technologies. Am J Law Med. 2008;34:225–55.PubMed
Metadaten
Titel
Modeling the Implementation of Universal Coverage for HIV Treatment as Prevention and its Impact on the HIV Epidemic
verfasst von
Roger Ying
Ruanne V. Barnabas
Brian G. Williams
Publikationsdatum
01.12.2014
Verlag
Springer US
Erschienen in
Current HIV/AIDS Reports / Ausgabe 4/2014
Print ISSN: 1548-3568
Elektronische ISSN: 1548-3576
DOI
https://doi.org/10.1007/s11904-014-0232-x

Weitere Artikel der Ausgabe 4/2014

Current HIV/AIDS Reports 4/2014 Zur Ausgabe

Behavioral-Bio-Medical Interface (JL Brown and RJ DiClemente, Section Editors)

Palliative HIV Care: Opportunities for Biomedical and Behavioral Change

Treatment as Prevention (RM Granich, Section Editor)

Treatment as Prevention—Where Next?

Behavioral-Bio-Medical Interface (JL Brown and RJ DiClemente, Section Editors)

Review of Recent Behavioral Interventions Targeting Older Adults Living with HIV/AIDS

Behavioral-Bio-Medical Interface (JL Brown and RJ DiClemente, Section Editors)

Optimizing ART Adherence: Update for HIV Treatment and Prevention

Behavioral-Bio-Medical Interface (JL Brown and RJ DiClemente, Section Editors)

Contraceptive Methods and Risk of HIV Acquisition or Female-to-Male Transmission

Behavioral-Bio-Medical Interface (JL Brown and RJ DiClemente, Section Editors)

Combination HIV Prevention Interventions: The Potential of Integrated Behavioral and Biomedical Approaches

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Reizdarmsyndrom: Diäten wirksamer als Medikamente

29.04.2024 Reizdarmsyndrom Nachrichten

Bei Reizdarmsyndrom scheinen Diäten, wie etwa die FODMAP-arme oder die kohlenhydratreduzierte Ernährung, effektiver als eine medikamentöse Therapie zu sein. Das hat eine Studie aus Schweden ergeben, die die drei Therapieoptionen im direkten Vergleich analysierte.

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.