title: Antiretroviral therapy needs: the effect of changing global guidelines.
abstract: BACKGROUND
  In 2010 the WHO issued a revision of the guidelines on antiretroviral therapy (ART) for HIV infection in adults and adolescents. The recommendations included earlier diagnosis and treatment of HIV in the interest of a longer and healthier life. The current analysis explores the impact on the estimates of treatment needs of the new criteria for initiating ART compared with the previous guidelines.
  
  
  METHODS
  The analyses are based on the national models of HIV estimates for the years 1990-2009. These models produce time series estimates of ART treatment need and HIV-related mortality. The ART need estimates based on ART eligibility criteria promoted by the 2010 WHO guidelines were compared with the need estimates based on the 2006 WHO guidelines.
  
  
  RESULTS
  With the 2010 eligibility criteria, the proportion of people living with HIV currently in need of ART is estimated to increase from 34% to 49%. Globally, the need increases from 11.4 million (10.2-12.5 million) to 16.2 million (14.8-17.1 million). Regional differences include 7.4 million (6.4-8.4 million) to 10.6 million (9.7-11.5 million) in sub-Saharan Africa, 1.6 million (1.3-1.7 million) to 2.4 million (2.1-2.5 million) in Asia and 710 000 (610 000-780 000) to 950 000 (810 000-1.0 million) in Latin America and the Caribbean.
  
  
  CONCLUSIONS
  When adopting the new recommendations, countries have to adapt their planning process in order to accelerate access to life saving drugs to those in need. These recommendations have a significant impact on resource needs. In addition to improving and prolonging the lives of the infected individuals, it will have the expected benefit of reducing HIV transmission and the future HIV/AIDS burden.
authors.affiliation: UNAIDS, 20 Avenue Appia, 1211 Geneva 27, Switzerland. staneckik@unaids.org
authors.forename: Karen
authors.initials: K
authors.lastname: Stanecki
authors.forename: Juliana
authors.initials: J
authors.lastname: Daher
authors.forename: John
authors.initials: J
authors.lastname: Stover
authors.forename: Michel
authors.initials: M
authors.lastname: Beusenberg
authors.forename: Yves
authors.initials: Y
authors.lastname: Souteyrand
authors.forename: Jesus M
authors.initials: JM
authors.lastname: García Calleja
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D017281:Cost of Illness; D003906:Developing Countries / Q000706:statistics & numerical data*; D004608:Eligibility Determination / Q000379:methods; D014943:Global Health; D015658:HIV Infections / Q000188:drug therapy*; D006297:Health Services Accessibility; D006801:Humans; D008875:Middle Aged; D020380:Needs Assessment; D017410:Practice Guidelines as Topic; D014944:World Health Organization; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents