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REVIEW
Contents Vol 11(2)

Current status of HIV treatment in Asia and the Pacific region

Angsana Phuphuakrat A , Sasisopin Kiertiburanakul A and Somnuek Sungkanuparph A B
+ Author Affiliations
- Author Affiliations

A Division of Infectious Diseases, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.

B Corresponding author. Email: somnuek.sun@mahidol.ac.th

Sexual Health 11(2) 119-125 https://doi.org/10.1071/SH13045
Submitted: 1 April 2013  Accepted: 28 October 2013   Published: 17 January 2014

Abstract

Asia and the Pacific represent a diverse group of nations facing HIV epidemic profiles of differing severity. Compared to other parts of the world, the burden of HIV disease is high in this region because of its large populations. At the end of 2011, 5 million people were living with HIV in Asia and the Pacific. This accounted for 15% of people living with HIV worldwide. The prevalence of people living with HIV, as well as access to HIV treatment and care, varies widely between countries. Differences between high-income economies and the rest of the continent are remarkable. Many high-income countries provide antiretroviral therapy (ART) to their citizens. Middle- and low-income countries have rapid ART scale-up and are dependent on international funding. This may compromise the sustainability of ART availability. In addition, lack of access to second- and third-line therapy remains a problem in many countries. The global goal of achieving universal access to ART by 2015 requires mainly low- and middle-income countries to be targeted. Regional policy should be developed in order to identify new infections in key populations, to start earlier treatment, to retain patients in care and to maintain funding.

Additional keywords: access to health care, AIDS, antiretroviral therapy.


References

[1]  Joint United Nations Programme on HIV/AIDS (UNAIDS). Regional fact sheet 2012 Asia and the Pacific. Geneva: UNAIDS; 2012. Available online at: http://www.unaids.org/en/media/unaids/contentassets/documents/epidemiology/2012/gr2012/2012_FS_regional_asia_pacific_en.pdf [verified November 2013].

[2]  Kerr S, Ruxrungtham K. ‘HIV transmission and its prevention in Asia’ In Volberding PA, Sande MA, Greene WC, Lange JMA, editors. Global HIV/AIDS medicine, 1st edn. New York: Elsevier; 2008. pp. 577–85.

[3]  Joint United Nations Programme on HIV/AIDS (UNAIDS). HIV in Asia and the Pacific: getting to zero. Geneva: UNAIDS; 2011.

[4]  Joint United Nations Programme on HIV/AIDS (UNAIDS). AIDSinfo online atabase. Geneva: UNAIDS; 2012. Available online at: http://aidsinfoonline.org [verified November 2013].

[5]  Kaiser Family Foundation. US global health policy 2013. Menlo Park: Kaiser Family Foundation; 2013. Available online at: http://www.globalhealthfacts.org/ [verified November 2013].

[6]  TREAT Asia. TREAT Asia special report: expanded availability of HIV/AIDS drugs in Asia creates urgent need for trained doctors. Bangkok: TREAT Asia; 2004. Available online at: http://www.amfar.org/uploadedFiles/Articles/Articles/Around_The_World/TreatAsia/TREAT_Asia_Special_Report%20-%20Doctor%20Shortage.pdf [verified November 2013].

[7]  Wilson DP. HIV treatment as prevention: natural experiments highlight limits of antiretroviral treatment as HIV prevention. PLoS Med 2012; 9 e1001231
| HIV treatment as prevention: natural experiments highlight limits of antiretroviral treatment as HIV prevention.Crossref | GoogleScholarGoogle Scholar | 22807656PubMed |

[8]  Verrall AJ, Olszyna DP, Huggan PJ, Chew N, Yong LL, Koh A, et al. Access to antiretrovirals in Singapore: where north meets south. Proceedings of the 6th IAS Conference on HIV Pathogenesis, Treatment and Prevention; 2011 July 17–20; Rome, Italy. Abstract CDB342.

[9]  World Health Organization (WHO). Antiretroviral therapy for HIV infection in adults and adolescents. Recommendations for a public health approach 2010 revision. Geneva: WHO; 2010. Available online at: http://whqlibdoc.who.int/publications/2010/9789241599764_eng.pdf [verified November 2013].

[10]  Ma Y, Zhang F, Zhao Y, Zang C, Zhao D, Dou Z, et al Cohort profile: the Chinese national free antiretroviral treatment cohort. Int J Epidemiol 2010; 39 973–9.
| Cohort profile: the Chinese national free antiretroviral treatment cohort.Crossref | GoogleScholarGoogle Scholar | 19556327PubMed |

[11]  Ministry of Health of the People’s Republic of China (MHPRC). 2012 China AIDS response progress report. Beijing: MHPRC; 2012. Available online at: http://www.unaids.org/en/dataanalysis/knowyourresponse/countryprogressreports/2012countries/ce_CN_Narrative_Report[1].pdf [verified November 2013].

[12]  National AIDS Authority (NAA). Cambodia country profile on HIV and AIDS: onwards towards universal access 2009–2010. Phnom Penh: NAA; 2010. Available online at: http://www.aidsdatahub.org/dmdocuments/Cambodia_Country_Profile_2011.pdf [verified November 2013].

[13]  Disease Control Division, Ministry of Health Malaysia. Global AIDS response progress report 2012. Prutajaya: Ministry of Health Malaysia; 2012. Available online at: http://www.aidsdatahub.org/dmdocuments/UNGASS_2012_Malaysia_Narrative_Report.pdf [verified November 2013].

[14]  Royal Thai Government. Thailand AIDS response progress report 2012: status at a glance 2012. Bangkok: Royal Thai Government; 2012. Available online at: http://www.aidsdatahub.org/dmdocuments/UNGASS_2012_Thailand_Narrative_Report.pdf [verified November 2013].

[15]  Oyomopito R, Lee MP, Phanuphak P, Lim PL, Ditangco R, Zhou J, et al Measures of site resourcing predict virologic suppression, immunologic response and HIV disease progression following highly active antiretroviral therapy (HAART) in the TREAT Asia HIV Observational Database (TAHOD). HIV Med 2010; 11 519–29.
| Measures of site resourcing predict virologic suppression, immunologic response and HIV disease progression following highly active antiretroviral therapy (HAART) in the TREAT Asia HIV Observational Database (TAHOD).Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC3cXhtFOhsr3L&md5=77696d9d1a940f0bd5127fc35821c789CAS | 20345881PubMed |

[16]  Kiertiburanakul S, Chotiprasitsakul D, Atamasirikul K, Sungkanuparph S. Late and low compliance with hepatitis B serology screening among HIV-infected patients in a resource-limited setting: an issue to improve HIV care. Curr HIV Res 2011; 9 54–60.
| Late and low compliance with hepatitis B serology screening among HIV-infected patients in a resource-limited setting: an issue to improve HIV care.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC3MXjtVagsrw%3D&md5=b4a58483a8742d1d4966c2636afb20d2CAS | 21198430PubMed |

[17]  Sungkanuparph S, Wongprasit P, Manosuthi W, Atamasirikul K. Compliance with hepatitis B and hepatitis C virus infection screening among HIV-1 infected patients in a resource-limited setting. Southeast Asian J Trop Med Public Health 2008; 39 863–6.
| 19058581PubMed |

[18]  Zhou J, Tanuma J, Chaiwarith R, Lee CK, Law MG, Kumarasamy N, et al Loss to follow-up in HIV-infected patients from Asia–Pacific region: results from TAHOD. AIDS Res Treat 2012; 375217
| Loss to follow-up in HIV-infected patients from Asia–Pacific region: results from TAHOD.Crossref | GoogleScholarGoogle Scholar | 22461979PubMed |

[19]  Hamers RL, Oyomopito R, Kityo C, Phanuphak P, Siwale M, Sungkanuparph S, et al Cohort profile: the PharmAccess African (PASER-M) and the TREAT Asia (TASER-M) monitoring studies to evaluate resistance – HIV drug resistance in sub-Saharan Africa and the Asia–Pacific. Int J Epidemiol 2012; 41 43–54.
| Cohort profile: the PharmAccess African (PASER-M) and the TREAT Asia (TASER-M) monitoring studies to evaluate resistance – HIV drug resistance in sub-Saharan Africa and the Asia–Pacific.Crossref | GoogleScholarGoogle Scholar | 21071386PubMed |

[20]  Sohn AH, Srikantiah P, Sungkanuparph S, Zhang F. Transmitted HIV drug resistance in Asia. Curr Opin HIV AIDS 2013; 8 27–33.
| Transmitted HIV drug resistance in Asia.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC3sXjvFeqsr0%3D&md5=0c848daee424a46da94c78269ee1e3e1CAS | 23196932PubMed |

[21]  Zhou J, Li PC, Kumarasamy N, Boyd M, Chen YM, Sirisanthana T, et al Deferred modification of antiretroviral regimen following documented treatment failure in Asia: results from the TREAT Asia HIV Observational Database (TAHOD). HIV Med 2010; 11 31–9.
| Deferred modification of antiretroviral regimen following documented treatment failure in Asia: results from the TREAT Asia HIV Observational Database (TAHOD).Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC3cXhtFOnu7o%3D&md5=b1a205d2cd7fd183e34690079f05ce4eCAS | 19601993PubMed |

[22]  Joint United Nations Programme on HIV/AIDS (UNAIDS). UNAIDS report on the global AIDS epidemic 2012. Geneva: UNAIDS; 2012. Available online at: http://www.unaids.org/en/media/unaids/contentassets/documents/epidemiology/2012/gr2012/20121120_UNAIDS_Global_Report_2012_en.pdf [verified November 2013].

[23]  Joint United Nations Programme on HIV/AIDS (UNAIDS), World Health Organisation and United Nations Development Programme. Using TRIPS flexibilities to improve access to HIV treatment. Geneva: UNAIDS; 2011. Available online at: http://www.undp.org/content/dam/undp/library/hivaids/Using%20TRIPS%20Flexibility%20to%20improve%20access%20to%20HIV%20treatment.pdf [verified November 2013].

[24]  Public Citizen Inc. and Public Citizen Foundation. Indonesia licenses patents for seven HIV & hepatitis B medicines. Washington, DC: Public Citizen; 2012. Available online at: http://www.citizen.org/PC-statement-on-compulsory-licensing-in-Indonesia [verified November 2013].

[25]  Pujari SN, Patel AK, Naik E, Patel KK, Dravid A, Patel JK, et al Effectiveness of generic fixed-dose combinations of highly active antiretroviral therapy for treatment of HIV infection in India. J Acquir Immune Defic Syndr 2004; 37 1566–9.
| Effectiveness of generic fixed-dose combinations of highly active antiretroviral therapy for treatment of HIV infection in India.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BD2cXhtVertbzN&md5=e14ce6152c8bbc3eb6e147bf9dbe52acCAS | 15577409PubMed |

[26]  Desakorn V, Karmacharya BM, Thanachartwet V, Kyaw NL, Tansuphaswadikul S, Sahassananda D, et al Effectiveness of fixed-dose combination stavudine, lamivudine and nevirapine (GPO-VIR) for treatment of naive HIV patients in Thailand: a 3-year follow-up. Southeast Asian J Trop Med Public Health 2011; 42 1414–22.
| 1:CAS:528:DC%2BC38XhtFCjtrg%3D&md5=ef8ae1e8bc78f7a937b02f12382af78fCAS | 22299411PubMed |

[27]  Kumarasamy N, Solomon S, Chaguturu SK, Cecelia AJ, Vallabhaneni S, Flanigan TP, et al The changing natural history of HIV disease: before and after the introduction of generic antiretroviral therapy in southern India. Clin Infect Dis 2005; 41 1525–8.
| The changing natural history of HIV disease: before and after the introduction of generic antiretroviral therapy in southern India.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD2MrltlOksg%3D%3D&md5=8103e1178e7ddb2986349b27c97a9618CAS | 16231268PubMed |

[28]  Kee MK, Lee JH, Kim EJ, Lee J, Nam JG, Yoo BH, et al Improvement in survival among HIV-infected individuals in the Republic of Korea: need for an early HIV diagnosis. BMC Infect Dis 2009; 9 128
| Improvement in survival among HIV-infected individuals in the Republic of Korea: need for an early HIV diagnosis.Crossref | GoogleScholarGoogle Scholar | 19671189PubMed |

[29]  The Australasian Society for HIV Medicine (ASHM). 2013 ARV guidelines with Australian commentary. Surry Hills: ASHM; 2013. Available online at: http://arv.ashm.org.au/ [verified November 2013].

[30]  Chinese Medical Association and Chinese Center for Disease Control and Prevention Guidelines for diagnosis and treatment of HIV/AIDS in China (2005). Chin Med J (Engl) 2006; 119 1589–608.
| 17042972PubMed |

[31]  Sungkanuparph S, Techasathit W, Utaipiboon C, Chasombat S, Bhakeecheep S, Leechawengwongs M, et al Thai national guidelines for antiretroviral therapy in HIV-1 infected adults and adolescents 2010. Asian Biomed 2010; 4 515–28.
| 1:CAS:528:DC%2BC3cXht1OlsrzJ&md5=b67bccdaede19d3ddbb61e45320f9581CAS |

[32]  National Committee for AIDS, Drugs and Prostitution Prevention and Control (NCADPPC). Vietnam AIDS response progress report 2012. Hanoi: NCADPPC; 2012. Available online at: http://www.unaids.org/en/dataanalysis/knowyourresponse/countryprogressreports/ 2012countries/ce_VN_Narrative_Report.pdf [verified November 2013].

[33]  Renaud F. WHO survey on ARV use 2011. Geneva: World Health Organisation; 2011. Available online at: www.who.int/hiv/amds/capacity/arv_use_oct2011.pdf [verified November 2013].

[34]  Srasuebkul P, Calmy A, Zhou J, Kumarasamy N, Law M, Lim PL, et al Impact of drug classes and treatment availability on the rate of antiretroviral treatment change in the TREAT Asia HIV Observational Database (TAHOD). AIDS Res Ther 2007; 4 18
| Impact of drug classes and treatment availability on the rate of antiretroviral treatment change in the TREAT Asia HIV Observational Database (TAHOD).Crossref | GoogleScholarGoogle Scholar | 17868478PubMed |

[35]  Kiertiburanakul S, Boettiger D, Lee MP, Omar S, Tanuma J, Ng OT, et al. Time trends of CD4 cell count levels at the initiation of ART among Asian HIV+ patients. Proceedings of the 20th Conference on Retroviruses and Opportunistic Infections (CROI); 2013, March 3–6; Atlanta, GA. Abstract 1089.

[36]  World Health Organization (WHO). Antiretroviral therapy. Geneva: WHO; 2013. Available online at: http://www.who.int/hiv/topics/treatment/art/en/index.html [verified November 2013].

[37]  Zhou J, Paton NI, Ditangco R, Chen YM, Kamarulzaman A, Kumarasamy N, et al Experience with the use of a first-line regimen of stavudine, lamivudine and nevirapine in patients in the TREAT Asia HIV Observational Database. HIV Med 2007; 8 8–16.
| Experience with the use of a first-line regimen of stavudine, lamivudine and nevirapine in patients in the TREAT Asia HIV Observational Database.Crossref | GoogleScholarGoogle Scholar | 17305926PubMed |

[38]  Win MK, Leo YS, Chua A. Phasing out the use of stavudine in Singapore: how are we doing in compliance to World Health Organization (WHO) recommendations? Ann Acad Med Singapore 2012; 41 615–6.
| 23303121PubMed |

[39]  National AIDS Control Organisation. Antiretroviral therapy guidelines for HIV-infected adults and adolescents including post-exposure prophylaxis. New Delhi: Ministry of Health & Family Welfare Government of India; 2007. Available online at: http://nacoonline.org/upload/Policies%20&%20Guidelines/1.%20Antiretroviral%20Therapy%20Guidelines%20for%20HIV-Infected%20Adults%20and%20Adolescents%20Including%20Post-exposure.pdf [verified November 2013].

[40]  Avert. Preventing mother-to-child transmission of HIV. Horsham: Avert; 2012. Available online at: http://www.avert.org/motherchild.htm [verified November 2013].

[41]  Beyrer C, Abdool Karim Q. The changing epidemiology of HIV in 2013. Curr Opin HIV AIDS 2013; 8 306–10.
| The changing epidemiology of HIV in 2013.Crossref | GoogleScholarGoogle Scholar | 23743721PubMed |

[42]  van Griensven F, Thienkrua W, McNicholl J, Wimonsate W, Chaikummao S, Chonwattana W, et al Evidence of an explosive epidemic of HIV infection in a cohort of men who have sex with men in Thailand. AIDS 2013; 27 825–32.
| Evidence of an explosive epidemic of HIV infection in a cohort of men who have sex with men in Thailand.Crossref | GoogleScholarGoogle Scholar | 23169330PubMed |

[43]  Altman D, Aggleton P, Williams M, Kong T, Reddy V, Harrad D, et al Men who have sex with men: stigma and discrimination. Lancet 2012; 380 439–45.
| Men who have sex with men: stigma and discrimination.Crossref | GoogleScholarGoogle Scholar | 22819652PubMed |

[44]  Chan KY, Reidpath DD. Stigmatization of patients with AIDS: understanding the interrelationships between Thai nurses’ attitudes toward HIV/AIDS, drug use, and commercial sex. AIDS Patient Care STDS 2007; 21 763–75.
| Stigmatization of patients with AIDS: understanding the interrelationships between Thai nurses’ attitudes toward HIV/AIDS, drug use, and commercial sex.Crossref | GoogleScholarGoogle Scholar | 17949275PubMed |

[45]  Avert. HIV & AIDS stigma and discrimination. Horsham: Avert; 2012. Available online at: http://www.avert.org/hiv-aids-stigma.htm [verified November 2013]..

[46]  Wasti SP, van Teijlingen E, Simkhada P, Randall J, Baxter S, Kirkpatrick P, et al Factors influencing adherence to antiretroviral treatment in Asian developing countries: a systematic review. Trop Med Int Health 2012; 17 71–81.
| Factors influencing adherence to antiretroviral treatment in Asian developing countries: a systematic review.Crossref | GoogleScholarGoogle Scholar | 21967241PubMed |

[47]  Joint United Nations Programme on HIV/AIDS (UNAIDS). Annexes: UNAIDS report on the global AIDS epidemic 2012. Geneva: UNAIDS; 2012. Available online at: http://www.unaids.org/en/media/unaids/contentassets/documents/epidemiology/2012/gr2012/JC2417_GR%202012_Annexes_en.pdf [verified November 2013].

[48]  National AIDS Control Organisation. Annual report 2010–11. New Delhi: Ministry of Health & Family Welfare Government of India; 2011. Available online at: http://www.performance.gov.in/sites/default/files/departments/aids-control/Annual%20Report%202010-11.pdf [verified November 2013].