Person: Plaß, Dietrich
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Veröffentlichung Estimates of global, regional, and national incidence, prevalence, and mortality of HIV, 1980Ń2015: the Global Burden of Disease Study 2015(2016) Wang, Haidong; Wolock, Tim M.; Carter, Austin; Nguyen, Grant; Kyu, Hmwe Hmwe; Gakidou, Emmanuela; Hay, Simon I.; Mills, Edward J.; Trickey, Adam; Msemburl, William; Coates, Matthew M.; Mooney, Meghan D.; Fraser, Maya S.; Sligar, Amber; Salomon, Joshua; Larson, Heidi; Friedmann, Joseph; Abajobir, Amanuel Alemu; Abate, Kalkidan Hassen; Abbas, Kaja M.; Abd El Razek, Mohammed Magdy; Abd-Allah, Foad; Abdulle, Abdishakur M.; Abera, Semaw Ferede; Abubakar, Ibrahim; Abu-Raddad, Laith J.; Abu-Rmeileh, Niveen M. E.; Abyu, Gebre Yitayih; Adebiyi, Akindele Olupelumi; Adedeji, Isaac Akinkunmi; Adelekan, Ademola Lukman; Adofo, Koranteng; Adou, Arséne Kouablan; Ajala, Oluremi N.; Plaß, Dietrich; Akinyemiju, Tomi F.; Akseer, Nadia; Al Lami, Faris Hasan; Al-Aly, Ziyad; Alam, KhurshidBackground
Timely assessment of the burden of HIV/AIDS is essential for policy setting and programme evaluation. In this report from the Global Burden of Disease Study 2015 (GBD 2015), we provide national estimates of levels and trends of HIV/AIDS incidence, prevalence, coverage of antiretroviral therapy (ART), and mortality for 195 countries and territories from 1980 to 2015.
Methods
For countries without high-quality vital registration data, we estimated prevalence and incidence with data from antenatal care clinics and population-based seroprevalence surveys, and with assumptions by age and sex on initial CD4 distribution at infection, CD4 progression rates (probability of progression from higher to lower CD4 cell-count category), on and off antiretroviral therapy (ART) mortality, and mortality from all other causes. Our estimation strategy links the GBD 2015 assessment of all-cause mortality and estimation of incidence and prevalence so that for each draw from the uncertainty distribution all assumptions used in each step are internally consistent. We estimated incidence, prevalence, and death with GBD versions of the Estimation and Projection Package (EPP) and Spectrum software originally developed by the Joint United Nations Programme on HIV/AIDS (UNAIDS). We used an open-source version of EPP and recoded Spectrum for speed, and used updated assumptions from systematic reviews of the literature and GBD demographic data. For countries with high-quality vital registration data, we developed the cohort incidence bias adjustment model to estimate HIV incidence and prevalence largely from the number of deaths caused by HIV recorded in cause-of-death statistics. We corrected these statistics for garbage coding and HIV misclassification.
Findings
Global HIV incidence reached its peak in 1997, at 3ı3 million new infections (95% uncertainty interval [UI] 3ı1-3ı4 million). Annual incidence has stayed relatively constant at about 2ı6 million per year (range 2ı5-2ı8 million) since 2005, after a period of fast decline between 1997 and 2005. The number of people living with HIV/AIDS has been steadily increasing and reached 38ı8 million (95% UI 37ı6-40ı4 million) in 2015. At the same time, HIV/AIDS mortality has been declining at a steady pace, from a peak of 1ı8 million deaths (95% UI 1ı7-1ı9 million) in 2005, to 1ı2 million deaths (1ı1-1ı3 million) in 2015. We recorded substantial heterogeneity in the levels and trends of HIV/AIDS across countries. Although many countries have experienced decreases in HIV/AIDS mortality and in annual new infections, other countries have had slowdowns or increases in rates of change in annual new infections.
Interpretation
Scale-up of ART and prevention of mother-to-child transmission has been one of the great successes of global health in the past two decades. However, in the past decade, progress in reducing new infections has been slow, development assistance for health devoted to HIV has stagnated, and resources for health in low-income countries have grown slowly. Achievement of the new ambitious goals for HIV enshrined in Sustainable Development Goal 3 and the 90-90-90 UNAIDS targets will be challenging, and will need continued efforts from governments and international agencies in the next 15 years to end AIDS by 2030.
Funding
Bill & Melinda Gates Foundation, and National Institute of Mental Health and National Institute on Aging, National Institutes of Health.
Quelle: http://www.thelancet.comVeröffentlichung Global, regional, and national age-sex specific mortality for 264 causes of death, 1980-2016(2017) Naghavi, Mohsen; Abajobir, Amanuel Alemu; Abbafati, Cristiana; Plaß, DietrichVeröffentlichung Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2015(2016) Forouzanfar, Mohammad H.; Alexander, Lily; Anderson, H. Ross; Bhutta, Zulfiqar A.; Biryukov, Stan; Brauer, Michael; Burnett, Richard T.; Cercy, Kelly; Charlson, Fiona J.; Cohen, Aaron J.; Dandona, Lalit; Estep, Kara; Frostad, Joseph, J.; Ferrari, Alize J.; Fullman, Nancy; Gething, Peter W.; Godwin, William W.; Griswold, Max; Hay, Simon I.; Kinfu, Yohannes; Kyu, Hmwe H.; Larson, Heidi J.; Liang, Xiaofeng; Lim, Stephen S.; Liu, Patrick Y.; Lopez, Alan D.; Lozano, Rafael; Marczak, Laurie; Mensah, George A.; Mokdad, Ali H.; Moradi-Lakeh, Maziar; Naghavi, Mohsen; Neal, Bruce; Reitsma, Marissa B; Roth, Gregory A.; Salomon, Joshua A.; Sur, Patrick J.; Vos, Theo; Wagner, Joseph A.; Wang, Haidong; Zhao, Yi; Zhou, Maigeng; Aasvang, Gunn Marit; Abajobir, Amanuel Alemu; Abate, Kalkidan Hassen; Abbafati, Cristiana; Abbas, Kaja M.; Abd-Allah, Foad; Abdulle, Abdishakur M.; Abera, Semaw Ferede; Abraham, Biju; Abu-Raddad, Laith J.; Abyu, Gebre Yitayih; Adebiyi, Akindele Olupelumi; Adedeji, Isaac Akinkunmi; Ademi, Zanfina; Adou, Arsène Kouablan; Adsuar, José C.; Agardh, Emilie Elisabet; Agarwal, Arnav; Agrawal, Anurag; Ahmad Kiadaliri, Aliasghar; Ajala, Oluremi N.; Akinyemiju, Tomi F.; Al-Aly, Ziyad; Alam, Khurshid; Plaß, Dietrich; Alam, Noore K. M.; Aldhahri, Saleh Fahed; Aldridge, Robert William; Alemu, Zewdie Aderaw; Ali, Raghib; Tobollik, Myriam; Alkerwi, Ala'a; Alla, Francois; Allebeck, Peter; Alsharif, Ubai; Altirkawi, Khalid A.Background The Global Burden of Diseases, Injuries, and Risk Factors Study 2015 provides an up-to-date synthesis of the evidence for risk factor exposure and the attributable burden of disease. By providing national and subnational assessments spanning the past 25 years, this study can inform debates on the importance of addressing risks in context. Quelle: www.sciencedirect.comVeröffentlichung Global, regional, and national under-5 mortality, adult mortality, age-specific mortality, and life expectancy, 1970-2016(2017) Wang, Haidong; Abajobir, Amanuel Alemu; Abate, Kalkidan Hassen; Plaß, DietrichVeröffentlichung Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2016(2017) Gakidou, Emmanuela; Afshin, Ashkan; Abajobir, Amanuel Alemu; Plaß, Dietrich; Tobollik, MyriamVeröffentlichung Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016(2017) Vos, Theo; Abajobir, Amanuel Alemu; Abbafati, Christiana; Plaß, DietrichVeröffentlichung Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990-2015(2016) Kassebaum, Nicholas J.; Arora, Megha; Barber, Ryan M.; Bhutta, Zulfiqar A.; Brown, Jonathan P.; Carter, Austin; Casey, Daniel C.; Charlson, Fiona J.; Coates, Matthew M.; Coggeshall, Megan; Cornaby, Leslie; Dandona, Lalit; Dicker, Daniel J.; Erskine, Holly E.; Ferrari, Alize J.; Fitzmaurice, Christina; Foreman, Kyle J.; Forouzanfar, Mohammad H.; Fullman, Nancy; Gething, Peter W.; Goldberg, Ellen M.; Graetz, Nicholas; Haagsma, Juanita A.; Hay, Simon I.; Johnson, Catherine O.; Kemmer, Laura; Khalil, Ibrahim A.; Kinfu, Yohannes; Kutz, Michael J.; Kyu, Hmwe H.; Leung, Janni; Liang, Xiaofeng; Lim, Stephen S.; Lozano, Rafael; Mensah, George A.; Mikesell, Joe; Mokdad, Ali H.; Mooney, Meghan D.; Naghavi, Mohsen; Nguyen, Grant; Nsoesie, Elaine; Pigott, David M.; Pinho, Christine; Rankin, Zane; Reinig, Nikolas; Salomon, Joshua A.; Sandar, Logan; Smith, Alison M.; Sorensen, Reed J. D.; Stanaway, Jeffrey; Steiner, Caitlyn; Teeple, Stephanie; Troeger, Christopher; Truelsen, Thomas; VanderZanden, Amelia; Wagner, Joseph A.; Wanga, Valentine; Whiteford, Harvey A.; Zhou, Maigeng; Zoeckler, Leo; Abajobir, Amanuel Alemu; Plaß, Dietrich; Abate, Kalkidan Hassen; Abbafati, Cristiana; Abbas, Kaja M.; Abd-Allah, Foad; Abraham, Biju; Abubakar, Ibrahim; Abu-Raddad, Laith J.; Abu-Rmeileh, Niveen M. E.; Achoki, Tom; Ackerman, Ilana N.; Adebiyi, Akindele Olupelumi; Adedeji, Isaac Akinkunmi; Adsuar, José C.; Afanvi, Kossivi Agbelenko; Afshin, Ashkan; Agardh, Emilie Elisabet; Agarwal, ArnavHealthy life expectancy (HALE) and disability-adjusted life-years (DALYs) provide summary measures of health across geographies and time that can inform assessments of epidemiological patterns and health system performance, help to prioritise investments in research and development, and monitor progress toward the Sustainable Development Goals (SDGs). We aimed to provide updated HALE and DALYs for geographies worldwide and evaluate how disease burden changes with development. www.sciencedirect.com