Improving estimates of children living with HIV from the Spectrum AIDS Impact Model.
Improving estimates of children living with HIV from the Spectrum AIDS Impact Model.
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DOI：
10.1097/qad.0000000000001306
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发表时间：
2017-04
期刊：
影响因子：
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通讯作者：
Stover J
中科院分区：
文献类型：
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作者：
Mahy M;Penazzato M;Ciaranello A;Mofenson L;Yianoutsos CT;Davies MA;Stover J
艾滋病毒感染儿童的估计数量决定了规划和治疗需求。我们解释了 2015 年至 2016 年间联合国艾滋病规划署估计值的变化，并描述了这些估计值面临的挑战。国家工作队使用 Spectrum 软件对新感染儿童、艾滋病毒感染者和死于艾滋病的儿童进行了估计。频谱文件适用于 160 个国家/地区，占全球人口的 98%。 2016 年，这些方法进行了更新，以反映艾滋病毒母婴传播的最新证据，并改进了对儿童开始抗逆转录病毒治疗年龄的假设。我们使用 2016 年模型报告了更新的结果，并根据调查年度基于人口的调查中的母婴传播率和艾滋病毒流行率验证了这些估计值。修订后的 2016 年模型估计，2014 年感染艾滋病毒的儿童比 2015 年模型减少了 27%，这主要是由于怀孕期间感染艾滋病毒的妇女母婴传播概率发生了变化。修订后的估计数与基于人口的 5-9 岁儿童 HIV 传播和 HIV 流行率调查一致，但低于 10-14 岁儿童的调查。 2016年改款车型是对之前车型的改进。随着假设的进一步改进，儿童艾滋病毒模型将继续发展。商品预测和项目规划依赖于这些估计，提高准确性对于实现有效扩大规模和优化资源利用至关重要。需要努力改进儿童艾滋病毒流行率、发病率和死亡率的实证测量。
Estimated numbers of children living with HIV determine programmatic and treatment needs. We explain the changes made to the UNAIDS estimates between 2015 and 2016 and describe the challenges around these estimates. Estimates of children newly infected, living with HIV, and dying of AIDS are developed by country teams using Spectrum software. Spectrum files are available for 160 countries, which represent 98% of the global population. In 2016, the methods were updated to reflect the latest evidence on mother-to-child HIV transmission and improved assumptions on the age children initiate antiretroviral therapy. We report updated results using the 2016 model and validate these estimates against mother- to-child transmission rates and HIV prevalence from population-based surveys for the survey year. The revised 2016 model estimates 27% fewer children living with HIV in 2014 than the 2015 model, primarily due to changes in the probability of mother-to-child transmission among women with incident HIV during pregnancy. The revised estimates were consistent with population-based surveys of HIV transmission and HIV prevalence among children 5–9 years, but were lower than surveys among children 10–14 years. The revised 2016 model is an improvement on previous models. Paediatric HIV models will continue to evolve as further improvements are made to the assumptions. Commodities forecasting and programme planning rely on these estimates and increasing accuracy will be critical to enable effective scale-up and optimal use of resources. Efforts are needed to improve empirical measures of HIV prevalence, incidence and mortality among children.