Universal HIV testing could halt epidemic

Using computers to model epidemic dynamics with data from South Africa, researchers from the World Health Organization (WHO) showed in theory that universal voluntary HIV testing, with immediate antiretroviral treatment (ART) for those diagnosed positive, could practically halt AIDS in epidemic areas by reducing HIV cases by 95 per cent over 10 years.

The study, conducted by Dr Reuben Granich, of the Department of HIV/AIDS, WHO, Geneva, Switzerland, and colleagues, was published online in The Lancet r.

According to the authors, by the end of last year, about 3 million people worldwide have been treated with ART, but they estimated another 6.7 million who needed ART went untreated and another 2.7 million people became infected last year.

Using computer-based mathematical models on data from South Africa, and assuming all HIV transmission was heterosexual, Granich and colleagues explored in theory how testing everyone over the age of 15 for HIV every year, and treating infected people with ART straight away, affected the case reproduction rate and long term dynamics of HIV spread in a generalized epidemic.

They found that such a strategy would within 10 years reduce the incidence of HIV in an epidemic population from 20 per 1000 people to 1 per 1000, a fall of 95%.

Granich and colleagues also suggested the current endemic phase where most HIV positive adults are not receiving ART could within 5 years rapidly become an elimination phase where most adults with HIV were receiving ART.