SEATTLE Treatment as prevention strategy resulted
in significant reductions in HIV incidence in a sub-Saharan African setting
where the incidence for HIV acquisition is high, according to Frank Tanser,
Tanser and colleagues hypothesized that the rollout of
increased ART coverage would lead to a decreased risk for HIV within the
surrounding community of a rural hyper-endemic setting in sub-Saharan Africa.
We wanted to see if we could use observational
data we collected to test the treatment as prevention hypothesis in
a real-world sub-Saharan African setting, he said. This area has an
incredibly high rate for acquiring HIV infection. The lifetime risk of
acquiring HIV is 80% in females and 70% among males this is incredibly
high. Since 2004, there has been a rapid rollout of ART and between 2004 and
2011 about 20,000 individuals were initiated on treatment.
Data were pooled on adults aged 15 years and older
included in the longitudinal HIV and demographic surveillance South Africa
program (n=10,000 people/year). The researchers compiled spatial variation
estimates in the proportion of HIV infected adults taking ART between 2004 and
A group of HIV-negative adults aged 15 years and older
(n=16,588) were also followed during the same time period. The effect of ART on
the surrounding local community was assessed on the risk for HIV.
Researchers observed a crude incidence rate in HIV
seroconversions of 2.63 per 100 person-years (95% CI, 2.5-2.77). In addition,
the researchers detected a 1.7% decrease in HIV acquisition faced by an
HIV-negative adult living in the surrounding community.
These results clearly demonstrate that the rate of
new HIV infections can be reduced as a result of high coverage of ART and this
can be done in the real-world sub-Saharan African setting. This is the first
evidence recorded to date in this type of setting, Tanser said.
For more information:
- Tanser F. #136LB. Presented at: the 19th Conference on Retroviruses and
Opportunistic Infections. March 5-8, 2012; Seattle.
Disclosures: The researchers report no relevant
To underscore the importance of rolling ART would have an impact beyond
just mortality and morbidity related to HIV infection.
James Hakim, MD
University of Zimbabwe
College of Health Science