Predicting the long-term impact of antiretroviral therapy scale-up on population incidence of tuberculosis

Simple item page
dc.contributor.authorDodd, Peter Jen_ZA
dc.contributor.authorKnight, Gwenan Men_ZA
dc.contributor.authorLawn, Stephen Den_ZA
dc.contributor.authorCorbett, Elizabeth Len_ZA
dc.contributor.authorWhite, Richard Gen_ZA
dc.date.accessioned2015-11-23T12:25:43Z
dc.date.available2015-11-23T12:25:43Z
dc.date.issued2013en_ZA
dc.description.abstractObjective To investigate the impact of antiretroviral therapy (ART) on long-term population-level tuberculosis disease (TB) incidence in sub-Saharan Africa. METHODS: We used a mathematical model to consider the effect of different assumptions about life expectancy and TB risk during long-term ART under alternative scenarios for trends in population HIV incidence and ART coverage. RESULTS: All the scenarios we explored predicted that the widespread introduction of ART would initially reduce population-level TB incidence. However, many modelled scenarios projected a rebound in population-level TB incidence after around 20 years. This rebound was predicted to exceed the TB incidence present before ART scale-up if decreases in HIV incidence during the same period were not sufficiently rapid or if the protective effect of ART on TB was not sustained. Nevertheless, most scenarios predicted a reduction in the cumulative TB incidence when accompanied by a relative decline in HIV incidence of more than 10% each year. CONCLUSIONS: Despite short-term benefits of ART scale-up on population TB incidence in sub-Saharan Africa, longer-term projections raise the possibility of a rebound in TB incidence. This highlights the importance of sustaining good adherence and immunologic response to ART and, crucially, the need for effective HIV preventive interventions, including early widespread implementation of ART.en_ZA
dc.identifier.apacitationDodd, P. J., Knight, G. M., Lawn, S. D., Corbett, E. L., & White, R. G. (2013). Predicting the long-term impact of antiretroviral therapy scale-up on population incidence of tuberculosis. <i>PLoS One</i>, http://hdl.handle.net/11427/15281en_ZA
dc.identifier.chicagocitationDodd, Peter J, Gwenan M Knight, Stephen D Lawn, Elizabeth L Corbett, and Richard G White "Predicting the long-term impact of antiretroviral therapy scale-up on population incidence of tuberculosis." <i>PLoS One</i> (2013) http://hdl.handle.net/11427/15281en_ZA
dc.identifier.citationDodd, P. J., Knight, G. M., Lawn, S. D., Corbett, E. L., & White, R. G. (2013). Predicting the long-term impact of antiretroviral therapy scale-up on population incidence of tuberculosis. PloS one, 8(9), e75466. doi:10.1371/journal.pone.0075466en_ZA
dc.identifier.ris TY - Journal Article AU - Dodd, Peter J AU - Knight, Gwenan M AU - Lawn, Stephen D AU - Corbett, Elizabeth L AU - White, Richard G AB - Objective To investigate the impact of antiretroviral therapy (ART) on long-term population-level tuberculosis disease (TB) incidence in sub-Saharan Africa. METHODS: We used a mathematical model to consider the effect of different assumptions about life expectancy and TB risk during long-term ART under alternative scenarios for trends in population HIV incidence and ART coverage. RESULTS: All the scenarios we explored predicted that the widespread introduction of ART would initially reduce population-level TB incidence. However, many modelled scenarios projected a rebound in population-level TB incidence after around 20 years. This rebound was predicted to exceed the TB incidence present before ART scale-up if decreases in HIV incidence during the same period were not sufficiently rapid or if the protective effect of ART on TB was not sustained. Nevertheless, most scenarios predicted a reduction in the cumulative TB incidence when accompanied by a relative decline in HIV incidence of more than 10% each year. CONCLUSIONS: Despite short-term benefits of ART scale-up on population TB incidence in sub-Saharan Africa, longer-term projections raise the possibility of a rebound in TB incidence. This highlights the importance of sustaining good adherence and immunologic response to ART and, crucially, the need for effective HIV preventive interventions, including early widespread implementation of ART. DA - 2013 DB - OpenUCT DO - 10.1371/journal.pone.0075466 DP - University of Cape Town J1 - PLoS One LK - https://open.uct.ac.za PB - University of Cape Town PY - 2013 T1 - Predicting the long-term impact of antiretroviral therapy scale-up on population incidence of tuberculosis TI - Predicting the long-term impact of antiretroviral therapy scale-up on population incidence of tuberculosis UR - http://hdl.handle.net/11427/15281 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/15281
dc.identifier.urihttp://dx.doi.org/10.1371/journal.pone.0075466
dc.identifier.vancouvercitationDodd PJ, Knight GM, Lawn SD, Corbett EL, White RG. Predicting the long-term impact of antiretroviral therapy scale-up on population incidence of tuberculosis. PLoS One. 2013; http://hdl.handle.net/11427/15281.en_ZA
dc.language.isoengen_ZA
dc.publisherPublic Library of Scienceen_ZA
dc.publisher.departmentDesmond Tutu HIV Centreen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.en_ZA
dc.rights.holder© 2013 Dodd et alen_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/4.0en_ZA
dc.sourcePLoS Oneen_ZA
dc.source.urihttp://journals.plos.org/plosoneen_ZA
dc.subject.otherTuberculosisen_ZA
dc.subject.otherAntiretroviral therapyen_ZA
dc.subject.otherHIVen_ZA
dc.subject.otherLife expectancyen_ZA
dc.subject.otherHIV epidemiologyen_ZA
dc.subject.otherHIV preventionen_ZA
dc.subject.otherHIV infectionsen_ZA
dc.subject.otherDeath ratesen_ZA
dc.titlePredicting the long-term impact of antiretroviral therapy scale-up on population incidence of tuberculosisen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
Dodd_Predicting_Long_Term_Impact_ART_2013.pdf
Size:
739.32 KB
Format:
Adobe Portable Document Format
Description:
Download
Collections
Journal Articles