Prevalence of advanced HIV disease in sub-Saharan Africa: a multi-country analysis of nationally representative household surveys

作者：Dominik Stelzle, Ajay Rangaraj, Joseph N Jarvis, Nirina H Razakasoa, George Perrin, Daniel Low‐Beer, Meg Doherty, Nathan Ford, Shona Dalal · 发表于：The Lancet Global Health · 年份：2025 · DOI：10.1016/s2214-109x(24)00538-2 · 被引用次数：35 · 研究领域：HIV/AIDS Research and Interventions、HIV Research and Treatment、HIV-related health complications and treatments

BACKGROUND: Advanced HIV disease (AHD) is a critical stage in the progression of HIV infection and is associated with heightened susceptibility to opportunistic infections, malignancies, and other life-threatening complications. Estimates of the burden of AHD in sub-Saharan Africa are scarce but are needed for programme planning which includes the allocation of resources and the monitoring of outcomes. The aim of the study was to assess the prevalence of and the number of people living with HIV with AHD. METHODS: ). We analysed the prevalence of AHD by various demographic and socioeconomic factors; we then estimated the number of individuals with AHD in sub-Saharan Africa by combining these proportions with the latest UNAIDS HIV estimates for the region by the treatment and care cascade. We also assessed policies related to the provision of the recommended package of care for the diagnosis and management of AHD. FINDINGS: . AHD was more common among males than females (13·2% vs 8·0%) and differed across the treatment cascade: 15·4% among people living with HIV who did not know their HIV status, 20·9% among people who knew their status but were not on antiretroviral treatment (ART), 29·5% among people who were on ART but not virally suppressed, and 4·3% among people who were virally suppressed. Extrapolating these results to sub-Saharan Africa yielded an estimated 1·88 million people living with AHD (uncertainty interval [UI] 1·58-2·20); 920 000 (UI 770 000-1·07 million) femal...