Impact of HIV Drug Resistance on HIV/AIDS-Associated Mortality, New Infections, and Antiretroviral Therapy Program Costs in Sub-Saharan Africa.
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.
Institute for Global Health, University College London, United Kingdom.
Andrew N
AN
Phillips
Avenir Health, Glastonbury, Connecticut.
John
J
Stover
Institute for Global Health, University College London, United Kingdom.
Valentina
V
Cambiano
Institute for Global Health, University College London, United Kingdom.
Fumiyo
F
Nakagawa
Tufts University School of Medicine, Boston, Massachusetts.
Michael R
MR
Jordan
African Health Research Institute, KwaZulu-Natal, South Africa and Division of Infection and Immunity, University College London, United Kingdom.
Deenan
D
Pillay
World Health Organisation, Geneva, Switzerland.
Meg
M
Doherty
Centre for Health Economics, University of York, United Kingdom.
Paul
P
Revill
World Health Organisation, Geneva, Switzerland.
Silvia
S
Bertagnolio
D000293:Adolescent; D000328:Adult; D017954:Africa South of the Sahara / Q000453:epidemiology; D019380:Anti-HIV Agents / Q000191:economics / Q000494:pharmacology / Q000627:therapeutic use; D015331:Cohort Studies; D024882:Drug Resistance, Viral; D015658:HIV Infections / Q000188:drug therapy / Q000191:economics / Q000401:mortality / Q000821:virology; D015497:HIV-1 / Q000187:drug effects*; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D008962:Models, Theoretical; D055815:Young Adult
D019380:Anti-HIV Agents
 mathematical model.; HIV; cost; death; drug resistance; incidence