An international team of researchers from South Africa, the Netherlands, the UK and the US says that under the current system of testing and treating HIV/AIDS, the country is likely to be free of new infections within 24-34 years. If mandatory annual testing and universal treatment with antiretroviral drugs was introduced, however, the same results could be achieved ten years earlier, saving up to 1 380 million “life years” at a cost of R17bn.
The report, Elimination of HIV in South Africa through Expanded Access to Antiretroviral Therapy, has been published in the peer reviewed open access journal PLOS Medicine. The researchers sought to improve the statistical modelling used in previous papers published on the subject of testing, and found that the more factors included in the models, the faster the goal of reducing HIV infections was reached.
The authors found that current policy, which is to treat people with a CD4 cell count of fewer than 350 cells per microlitre of blood will eventually succeed in reducing the number of new HIV infections to less than 1 per 1 000 ‘person years’. CD4 cell counts are the primary indicated used in detecting the HIV virus through its effect on the immune system. In South Africa, where an estimated six million people are HIV-positive, it’s reckoned that 20% of cases aren’t being treated with ARVs or receive treatment too late. The report models the effect of universal testing and and treatment of all cases with ARVs would make the country free of new infections – statistically speaking – by 2027.
The authors of the report say that they believe a universal testing approach is cost effective – although stress more research is required – but “the required number of health workers and financial resources for such a strategy far exceeds the current availability in South Africa”.
The report comes at a time when HIV testing is high on the national agenda. In Cape Town yesterday, Deputy President Kgalema Mothlanthe urged all parliamentarians to set an example to their constituents by undertaking voluntary annual tests.
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