The Latest Treatment Numbers

The Latest Treatment Numbers

Tedd V. Ellerbrock, MD, FACOGCo-Chair, Adult Treatment Technical WorkgroupThe President's Emergency Plan for AIDS Relief

Team Leader, HIV Care and TreatmentGlobal AIDS Program, NCHHSTP

U.S. Centers for Disease Control and Prevention

Track 1.0 ART ProgramThe Emergency Plan for AIDS

Relief

Background

Track 1.0 ART Program

The Track 1.0 ART Program is funded and administered by HIV Care and Treatment Team, GAP, CDC and HIV/AIDS Bureau, HRSA

Four partners received Track 1.0 ART awards AIDSRelief (Catholic Relief Services Consortium)Elizabeth Glaser Pediatric AIDS Foundation (EGPAF)Harvard School of Public Health (Harvard)Mailman School of Public Health of Columbia University (Columbia)

The program was funded in February 2004

Program Year

Annual Funding (millions) Countries

Program/ Country Projects

Care and Treatment Facilities*

1 (2004-05) $92 11 21 119

2 (2005-06) $172 13 24 279

3 (2006-07) $206 13 24 478

4 (2007-08) $320 13 25 652

5 (2008-09) $443** 13 25


*at the end of the program year **funds requested


Relief

Program Totals

Countries where Partners have Implemented Track 1.0 ART Programs, as of March 31, 2008

Countryby Grantee

AIDSRELIEF EGPAF

HARVARD COLUMBIA TOTAL

Botswana X 1

Cote d’Ivoire X X 2

Ethiopia X 1

Guyana X 1

Haiti X 1

Kenya X X 2

Mozambique X X 2

Nigeria X X X 3

Rwanda X X 2

South Africa X X X 3

Tanzania X X X X 4

Uganda X 1

Zambia X X 2

TOTAL 9 5 3 8 25

No. of Track 1.0 Treatment Sitesby Country and Partner, as of March 31, 2008

Countryby Grantee

AIDSRELIEF EGPAF HARVARD

COLUMBIA TOTAL

Botswana 1* 1

Cote d’Ivoire 77 3 80

Ethiopia 40 40

Guyana 3 3

Haiti 8 8

Kenya 24 24 48

Mozambique 20 37 57

Nigeria 23 14 18 55

Rwanda 9 41 50

South Africa 27 28 37 92

Tanzania 31 51 14 31 127

Uganda 20 20

Zambia 17 54 71

TOTAL 162 230 29 231 652

*Indirect Support

No. of Persons Currently on ART by Country and Track 1.0 Partner, as of March 31, 2008

Countryby Grantee


COLUMBIA TOTAL

Botswana n/a* 0

Cote d’Ivoire 25,384 112 25,496

Ethiopia 19,458 19,458

Guyana 522 522

Haiti 2,706 2,706

Kenya 21,251 7,065 28,316

Mozambique 7,847 30,868 38,715

Nigeria 15,805 31,496 8,630 55,931

Rwanda 2,470 12,407 14,877

South Africa 15,007 41,316 21,958 78,281

Tanzania 15,151 18,141 15,664 9,630 58,586

Uganda 18,317 18,317

Zambia 20,370 71,705 92,075

TOTAL 111,599 164,393 47,160 110,128 433,280

*Indirect Support

No. of Children (<15 years) Currently on ARTby Country and Track 1.0 Partner, as of March 31, 2008

Countryby Grantee


COLUMBIA TOTAL

Botswana n/a* 0

Cote d’Ivoire 976 4 980

Ethiopia 1,317 1,317

Guyana 46 46

Haiti 176 176

Kenya 2,281 746 3,207

Mozambique 454 2,839 3,293

Nigeria 642 1,155 410 2,207

Rwanda 290 1,282 1,572

South Africa 1,231 4,950 1,970 8,151

Tanzania 1,128 4,633 1,443 676 4,880

Uganda 1,478 1,478

Zambia 1,332 4,671 6,003

TOTAL 8,604 12,684 2,598 9,244 33,130

*Indirect Support


As of March 31, 2008, 1,133,665 ever enrolled in palliative care741,007 currently receiving palliative care572,308 ever started on ART433,280 currently on ART

Of those on ART, 33,130 (8%) were children

Of adults on ART, 64% were females

Of children on ART, 50% were females





































Relief

No. of Persons on ARTby Partner

No. of Persons on ARTby Track 1.0 Partner

0

20,000

40,000

60,000

80,000

100,000

120,000

140,000

160,000

FY04

Q4

FY05

Q1

FY05

Q2

FY05

Q3

FY05

Q4

FY06

Q1

FY06

Q2

FY06

Q3

FY06

Q4

FY07

Q1

FY07

Q2

FY07

Q3

FY07

Q4

FY08

Q1

FY08

Q2

Ever Started Current Started in Quarter

AIDSRelief142,397

Ever StartedOn ART

78% on ART

16,669 patients/quarter


0

50,000

100,000

150,000

200,000

250,000

FY04

Q4

FY05

Q1

FY05

Q2

FY05

Q3

FY05

Q4

FY06

Q1

FY06

Q2

FY06

Q3

FY06

Q4

FY07

Q1

FY07

Q2

FY07

Q3

FY07

Q4

FY08

Q1

FY08

Q2


EGPAF


204,264Ever Started

On ART

80% on ART


0

10,000

20,000

30,000

40,000

50,000

60,000

70,000

80,000

90,000


Harvard

72% on ART


*

*No. of persons on ART in Botswana program is estimated at FY07Q1 and FY08Q2.

77,716Ever Started

On ART


0

30,000

60,000

90,000

120,000

150,000

FY04

Q4

FY05

Q1

FY05

Q2

FY05

Q3

FY05

Q4

FY06

Q1

FY06

Q2

FY06

Q3

FY06

Q4

FY07

Q1

FY07

Q2

FY07

Q3

FY07

Q4

FY08

Q1

FY08

Q2


Columbia

74% on ART


147,931Ever Started

On ART

No. of Persons on ARTin Track 1.0 Program

0

100,000

200,000

300,000

400,000

500,000

600,000

FY04

Q4

FY05

Q1

FY05

Q2

FY05

Q3

FY05

Q4

FY06

Q1

FY06

Q2

FY06

Q3

FY06

Q4

FY07

Q1

FY07

Q2

FY07

Q3

FY07

Q4

FY08

Q1

FY08

Q2


Program Totals

77% on ART


572,308Ever Started

On ART


Relief

Program Outcomes

Characteristics and Outcomes of Patients Ever Started on ART, as of September 30, 2007

Characteristicsand Outcomes No. of Patients

% of Patients ever started ART

Ever started ART 425,723

Sex

male 159,206 37.4%

female 266,510 62.6%

Age

Children (<15) 30,748 7.2%

Adults 394,968 92.8%

Facility level

primary 116,428 27.3%

secondary 211,679 49.7%

tertiary 97,616 22.9%

ART patient outcomes

Currently on ART 338,463 79.5%

Dead 27,326 6.4%

Lost to Follow-up 29,564 6.9%

Stopped 4,417 1.0%

Transferred out 23,801 5.6%





Sex

male 159,206 37.4%

female 266,510 62.6%

Age

Children (<15) 30,748 7.2%

Adults 394,968 92.8%

Facility level

primary 116,428 27.3%

secondary 211,679 49.7%

tertiary 97,616 22.9%



Dead 27,326 6.4%


Stopped 4,417 1.0%






Sex

male 159,206 37.4%

female 266,510 62.6%

Age

Children (<15) 30,748 7.2%

Adults 394,968 92.8%

Facility level

primary 116,428 27.3%

secondary 211,679 49.7%

tertiary 97,616 22.9%



Dead 27,326 6.4%


Stopped 4,417 1.0%






Sex

male 159,206 37.4%

female 266,510 62.6%

Age

Children (<15) 30,748 7.2%

Adults 394,968 92.8%

Facility level

primary 116,428 27.3%

secondary 211,679 49.7%

tertiary 97,616 22.9%



Dead 27,326 6.4%


Stopped 4,417 1.0%






Sex

male 159,206 37.4%

female 266,510 62.6%

Age

Children (<15) 30,748 7.2%

Adults 394,968 92.8%

Facility level

primary 116,428 27.3%

secondary 211,679 49.7%

tertiary 97,616 22.9%



Dead 27,326 6.4%


Stopped 4,417 1.0%






Sex

male 159,206 37.4%

female 266,510 62.6%

Age

Children (<15) 30,748 7.2%

Adults 394,968 92.8%

Facility level

primary 116,428 27.3%

secondary 211,679 49.7%

tertiary 97,616 22.9%



Dead 27,326 6.4%


Stopped 4,417 1.0%


Retention =Persons currently on ART

*cumulative proportion of patients by site

Track 1.0 ART Patient Cohort Retentionand Survival Probability, as of September 30, 2007

Persons ever started on ARTat an ART site

Modelled survival probability =

Lost*Stopped*

Ever on ART

Ever started ART then died*1

+-

- at an ARTsite

2

Modelled survival probability =

2

Lost*Stopped*

Ever on ART

Ever started ART then died*1

+-

-

*cumulative proportion of patients by site


at an ARTsite

Retention =Persons currently on ART

Persons ever started on ART

at an ART site


Category

Follow-Up Visit Cohort

6-Month 12-Month

No. of ART Facilities – reporting in quarter 547 547

No. of ART Facilities – reporting cohort data 360 312

Retention

Median retention (IQR) 82% (70% - 92%) 77% (65% - 90%)

Modelled Survival Probability

Median: dead as reported (IQR) 90% (83% - 96%) 88% (78% - 95%)

Analysis: varying lost to follow-up as dead

Median: 50% (IQR) 86% (77% - 94%) 83% (72% - 91%)

Median: 100% (IQR) 83% (71% - 93%) 79% (66% - 90%)


Category


6-Month 12-Month



Retention





Median: 50% (IQR) 86% (77% - 94%) 83% (72% - 91%)

Median: 100% (IQR) 83% (71% - 93%) 79% (66% - 90%)


Category


6-Month 12-Month



Retention





Median: 50% (IQR) 86% (77% - 94%) 83% (72% - 91%)

Median: 100% (IQR) 83% (71% - 93%) 79% (66% - 90%)

Track 1.0 ART Patient CohortCD4 Cell Count Change at 6 and 12 Months,

as of September 30, 2007

Category

Follow-up visit cohort

6-month 12-month

Number of ART facilities – reporting in quarter 547 547

Number of ART Facilities – reporting cohort data 360 312

Mean median CD4 cell count per µl

Baseline (SD) 146 (79) 142 (46)

Follow-up (SD) 279 (91) 304 (90)

Change from baseline to follow-up (SD) 133 (95) 161 (90)

Missing values: Mean of median CD4 count at baseline: 6-month n=351, 12-month n=299; Mean of median CD4 count at follow-up: 6-month n=335, 12-month n=292

Category

Follow-up visit cohort

6-month 12-month

Number of ART facilities – reporting in quarter 547 547

Number of ART Facilities – reporting cohort data 360 312

Mean median CD4 cell count per µL

Baseline (SD) 146 (79) 142 (46)

Follow-up (SD) 279 (91) 304 (90)

Change from baseline to follow-up (SD) 133 (95) 161 (90)

Missing values: Mean of median CD4 count at baseline: 6-month n=351, 12-month n=299; Mean of median CD4 count at follow-up: 6-month n=335, 12-month n=292.

Track 1.0 ART Patient CohortCD4 Cell Count Change at 6 and 12 Months,

as of September 30, 2007


Relief

Summary

153,909257,324

401,223560,802

1,358,500

822,068

1,640,9221,101,134

FY04APR

FY05SAPR

FY05APR

FY06SAPR

FY06APR

FY07SAPR

FY07APR

FY08SAPR

FY08APR

FY09 FY09

Number of People ReceivingTreatment End FY'09 Target (2,000,000) Projected increase

No. of Persons on ART in 15 Focus Countries Supported by PEPFAR during 2004-2008

No

. of P

erso

ns on A

RT

Contribution of Track 1.0 ART Program to Emergency Plan

As of March 31, 2008, the Track 1.0 ART Program supported

652 medical facilities in 25 country/partner programs in 13 countries

433,280 patients were on ART, which is ~ 26% of those on ART supported by PEPFAR


Track 1.0 ART ProgramPatient Outcomes

Of those who ever started on ART, about 80% were currently on treatment at their original facility

About 6% had died, 7% were lost to follow-up, 1% stopped treatment, and 6% transferred to another facility

At 312 facilities with 1-year follow-up data, the modelled survival probability at 1 year of treatment was 88% (IQR: 78% - 95%), while the average median CD4+ count increase at 1 year of treatment was 161 (SD: 90) cells/µL

The Latest Treatment Numbers

Documents

art programas

art programs

art programthe track

art programthe emergency

palliative care572

palliative care741

femalesof children

childrenof adults