<abstract xmlns="http://www.w3.org/1999/xhtml"><p>Prevalence estimates of human immunodeficiency virus (HIV) infection in Asia are diverse, ranging from &lt;0.1% to 1.1%. In Asia, approximately 4.7 million people are living with HIV and 310,000 are newly infected each year. The fastest growth of the epidemic throughout Asia is among men who have sex with men (MSM). Drug resistance varies from 4%-5% in an Asian cohort to 10% in an acutely infected MSM cohort in Bangkok. A rise (4%-14%) in the prevalence of syphilis is associated with the HIV epidemic in Asia. Tuberculosis is among the most common coinfections; however, HIV testing of tuberculosis patients is not routine. Coinfection with HBV, HCV, and triple coinfection varies from 8.7%-11%, 5%-18%, and 0.4%-3% respectively. Although the World Health Organization 2013 guidelines to start antiretroviral therapy (ART) early are implemented, most patients present late, with low CD4 counts, resulting in a high mortality during the first year of ART. While integrase inhibitor-based treatments are preferred first-line treatments in high income countries, efavirenz-based treatments remain preferred treatments in resource-limited countries. HIV-1 viral load testing is not available in most of these countries, making low-cost point-of-care testing accessibility an urgent priority. Effective ART coverage to prevent new HIV infections among children in Asia remains low. To provide life-long ART for children, better use of current first-line regimens and access to pediatric second-line formulations are important. To end AIDS in Asia by 2030, committed policy with innovative strategies to enhance “reach recruit, treat and retain” combined with effective prevention strategies are required.</p></abstract>

Prevalence estimates of human immunodeficiency virus (HIV) infection in Asia are diverse, ranging from <0.1% to 1.1%. In Asia, approximately 4.7 million people are living with HIV and 310,000 are newly infected each year. The fastest growth of the epidemic throughout Asia is among men who have sex with men (MSM). Drug resistance varies from 4%-5% in an Asian cohort to 10% in an acutely infected MSM cohort in Bangkok. A rise (4%-14%) in the prevalence of syphilis is associated with the HIV epidemic in Asia. Tuberculosis is among the most common coinfections; however, HIV testing of tuberculosis patients is not routine. Coinfection with HBV, HCV, and triple coinfection varies from 8.7%-11%, 5%-18%, and 0.4%-3% respectively. Although the World Health Organization 2013 guidelines to start antiretroviral therapy (ART) early are implemented, most patients present late, with low CD4 counts, resulting in a high mortality during the first year of ART. While integrase inhibitor-based treatments are preferred first-line treatments in high income countries, efavirenz-based treatments remain preferred treatments in resource-limited countries. HIV-1 viral load testing is not available in most of these countries, making low-cost point-of-care testing accessibility an urgent priority. Effective ART coverage to prevent new HIV infections among children in Asia remains low. To provide life-long ART for children, better use of current first-line regimens and access to pediatric second-line formulations are important. To end AIDS in Asia by 2030, committed policy with innovative strategies to enhance “reach recruit, treat and retain” combined with effective prevention strategies are required.

Human immunodeficiency virus and acquired immune deficiency syndrome in Asia: an update

Asian Biomedicine

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Prevalence estimates of human immunodeficiency virus (HIV) infection in Asia are diverse, ranging from <0.1% to 1.1%. In Asia, approximately 4.7 million people...

Guidelines	CD4	Remarks
U.S. DHHS 2015 [53]	All	When the patient is ready and committed to treatment
WHO 2013 [52] and most Asian countries	<500	Regardless of CD4 for specific settings and the patient is ready and committed to treatment
Thailand 2014 [54]	All	When the patient is ready and committed to treatment

Country	People living with HIV	Number of new infections	AIDS-related deaths
India	2,100,000	130,000	147,000
China	780,000	48,000	28,000
Indonesia	610,000	76,000	27,000
Thailand	450,000	9,000	19,000
Vietnam	260,000	13,000	12,500
Myanmar	200,000	7,100	12,000
Pakistan	87,000	19,000	3,500
Malaysia	82,000	7,400	5,200
Cambodia	76,000	1,400	2,700
Nepal	49,000	1200	4100
Papua New Guinea	25,000	<1000	<1000
Philippines	15,000	1,800	<500
LaoPDR	12,000	1,000	<500

Human immunodeficiency virus and acquired immune deficiency syndrome in Asia: an update

Article Category: Review article

Published Online: Mar 31, 2017

Page range: s3 - s14

DOI: https://doi.org/10.5372/1905-7415.1000.516

Keywords
AIDS, Asia, HIV

© 2016 Kiat Ruxrungthama, Stephen Kerr, Anchalee Avihingsanon, Nittaya Phanuphak, Pariya Ruxrungtham, Praphan Phanuphak

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Figure 1

Comparison of guideline recommendations for initiating antiretroviral therapy

Number of people living with human immunodeficiency virus (HIV), number of new infections and acquired immune deficiency syndrome (AIDS) related deaths in 2012, in Asian countries with the highest HIV burden [3,4],

Human immunodeficiency virus and acquired immune deficiency syndrome in Asia: an update

Article Category: Review article

Published Online: Mar 31, 2017

Page range: s3 - s14

DOI: https://doi.org/10.5372/1905-7415.1000.516

KeywordsAIDS, Asia, HIV

© 2016 Kiat Ruxrungthama, Stephen Kerr, Anchalee Avihingsanon, Nittaya Phanuphak, Pariya Ruxrungtham, Praphan Phanuphak

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Figure 1

Comparison of guideline recommendations for initiating antiretroviral therapy

Number of people living with human immunodeficiency virus (HIV), number of new infections and acquired immune deficiency syndrome (AIDS) related deaths in 2012, in Asian countries with the highest HIV burden [3,4],

Keywords
AIDS, Asia, HIV