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Reference Details
van de Vijver, David (2012), "Use of antiretroviral drugs for prevention of new infections with HIV".

Abstract:
Every year 2.5 million individuals become newly infected with HIV. This highlights that current ways for prevention of transmission, such as use of condoms, are not sufficient to limit the spread of HIV infection. Novel prevention strategies using antiretroviral drugs are being developed. One of these strategies is pre-exposure prophylaxis (PrEP) with antiretroviral drugs. The effect of drug resistance will be a critical issue in the use of PrEP. Drug resistance will reduce the effectiveness of PrEP. This detrimental effect could be counterbalanced by the reduced fitness of drug-resistant HIV, which may result in lower levels of virus particles. Because the amount of virus is a major determinant of the risk of transmission, drug-resistant HIV could be transmitted less easily. During the seminar I will discuss that the benefits of PrEP are expected to outweigh the risks associated with drug resistance (1.2). Another prevention strategy is “test and treat” in which testing positive for HIV is followed by treatment. HIV-testing can prevent new infections as individuals aware of their HIV-status can reduce their risk behaviour. Treatment of infected individuals can prevent new infections, as antiretroviral drugs can suppress the amount of virus to undetectable levels. Mathematical modelling has predicted that universal HIV testing followed by immediate start of antiretroviral drugs for those individuals who test positive, could reduce the HIV pandemic to one incident case of HIV per 1000 people within a decade (3). But, universal testing and immediate treatment may not be achieved in clinical practice in Africa (4) where most new infections occur World-wide. We used realistic data from a rural hospital in Macha in Zambia and used assumptions about testing and treatment that can be achieved in clinical practice. Using mathematical modelling we found that “test and treat” can strongly reduce the incidence of HIV but cannot eliminate the epidemic. “Test and treat” will lead to an increased prevalence of HIV as infected individuals will live longer.

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Highlights

This article is 'Highly accessed'  (total accesses to this article since publication: 1197) relative to age  in  BioMed Central:
Increasing risk behaviour can outweigh the benefits of antiretroviral drug treatment on the HIV incidence among men-having-sex-with-men in Amsterdam
Shan Mei, Rick Quax, David VAN de Vijver, Yifan Zhu and P.m.a. Sloot BMC Infectious Diseases, 11:118   (11 May 2011)

As of August 27, the most downloaded/accessed paper in BMC Systems Biology is: D. van Dijk et al.: Identifying potential survival strategies of HIV-1 through virus-host protein interaction networks, BMC Systems Biology, vol. 4, nr 1 pp. 96+17. 2010.

This paper received the ICCS best paper award 2010:
N. Zarrabi et al.: Modeling HIV-1 intracellular replication,
Procedia Computer Science vol. 1, nr 1 pp. 555-564. Elsevier B.V., Amsterdam, May 2010.

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