Impact of HIV Drug Resistance on HIV/AIDS-Associated Mortality, New Infections, and Antiretroviral Therapy Program Costs in Sub-Saharan Africa

J Infect Dis. 2017 May 1;215(9):1362-1365. doi: 10.1093/infdis/jix089.

Abstract

To inform the level of attention to be given by antiretroviral therapy (ART) programs to HIV drug resistance (HIVDR), we used an individual-level model to estimate its impact on future AIDS deaths, HIV incidence, and ART program costs in sub-Saharan Africa (SSA) for a range of program situations. We applied this to SSA through the Spectrum-Goals model. In a situation in which current levels of pretreatment HIVDR are over 10% (mean, 15%), 16% of AIDS deaths (890 000 deaths), 9% of new infections (450 000), and 8% ($6.5 billion) of ART program costs in SSA in 2016-2030 will be attributable to HIVDR.

Keywords: mathematical model.; HIV; cost; death; drug resistance; incidence.

MeSH terms

  • Adolescent
  • Adult
  • Africa South of the Sahara / epidemiology
  • Anti-HIV Agents* / economics
  • Anti-HIV Agents* / pharmacology
  • Anti-HIV Agents* / therapeutic use
  • Cohort Studies
  • Drug Resistance, Viral*
  • HIV Infections* / drug therapy
  • HIV Infections* / economics
  • HIV Infections* / mortality
  • HIV Infections* / virology
  • HIV-1 / drug effects*
  • Humans
  • Incidence
  • Middle Aged
  • Models, Theoretical
  • Young Adult

Substances

  • Anti-HIV Agents