Epidemiological study provides clues to design new strategies to reduce HIV-related mortality in China

In China, HIV-related deaths are on the rise, despite years of government efforts to control them. In an attempt to overcome this problem, a new study published in Chinese Medical Journal has dug deep into HIV-related data for nearly 30 years. The findings provide clues and trends that can help policymakers design new strategies to reduce HIV-related mortality in China.

In a new epidemiology-based study, researchers unveil important trends in the prevalence, incidence and mortality associated with the HIV epidemic in China. Photo courtesy: Anna Shvets of Pexels

For decades, human immunodeficiency virus (HIV) infections and acquired immunodeficiency syndrome (AIDS) have been a serious health problem around the world. Despite various global initiatives to control the spread and clinical advances, including the development of antiretroviral drugs, the epidemic remains a major public health problem.

In China, thanks to the tremendous efforts of the national government, HIV cases have declined; however, data showed that approximately 1.25 million people were still living with HIV in 2018. In addition, in 2019, the number of people dying each year from AIDS was five times that of all other diseases. infectious diseases combined. Thus, to control the burden of HIV / AIDS, it is imperative to review the epidemiology of the disease, in order to find trends that can lead to effective control strategies.

To this end, researchers from the China Center for Disease Control and Prevention, China, and the University of California, United States, have come together to study trends in the progression of HIV / AIDS in the country. over the past 28 years. The team conducted a detailed analysis of the 2017 Global Burden of Disease (GBD), Injury and Risk Factor study data, focusing on trends in prevalence, incidence and mortality. from 1990 to 2017. Briefly, these parameters are calculated by dividing the estimated number of cases, new infections and deaths, respectively, by the total population and presented by 100,000, in a study recently published in Chinese Medical Journal.

Lead author Professor Zun-You Wu, corresponding author of the study, explains common obstacles when working with such epidemiological data, “For a country like China, the data included in GBD often only included vital details. To retrieve other essential information necessary for the analysis and to deal with the biases that are an integral part of this data, we applied various epidemiological models and statistical methods. The result was a comprehensive picture of China’s HIV / AIDS scenario that spanned various demographic groups and subgroups.. “

These results give us an overview of HIV / AIDS trends in China. From 1990 to 2017, the total number of HIV / AIDS-related deaths in China increased from 3,337 to 34,800. From 1990 to 2009, the country experienced a significant increase in the prevalence of HIV / AIDS, which subsequently remained stable. until 2017. The period from 1990 to 2005 was also marked by a similar increase in the incidence of HIV, which then showed a decrease in 2017. However, the AIDS-related death rate increased from 1990 to 2004 and, after stabilizing until 2013, increased significantly from 2013 to 2017. Throughout the study period, the prevalence of HIV / AIDS was higher in men than in women.

The reduction in the prevalence and incidence of the disease in recent years has highlighted the positive impact of the various intervention strategies employed by the Chinese government. However, Professor Wu shares his concern, “Despite its successes in tackling the epidemic, China is failing to reduce HIV-related deaths, especially among men. This highlights the need to launch effective strategies to tackle high death rates. “

In this study, Professor Wu and his colleagues shared important insights that can help policymakers come up with better strategies, such as early identification and diagnosis of people living with HIV and improved treatment that includes services, high quality follow-up and support. In addition, holding patients for the entire period of treatment and avoiding discontinuation of treatment can significantly reduce the death rate. The study also highlights the need to design strategies that focus on demographically vulnerable and marginalized subgroups.

Overall, Professor Wu is optimistic about the implications of their findings.

By intensifying targeted efforts, in the coming years, China will be able to reduce AIDS-related mortality and control the HIV / AIDS epidemic.. “

Teacher. Zun-You Wu, Senior Author, China Center for Disease Control and Prevention