Futures Institute, 41A New London Turnpike, Glastonbury, Connecticut 6033, USA.
Sex Transm Infect. 2012 Dec;88 Suppl 2(Suppl_2):i11-6. doi: 10.1136/sextrans-2012-050640.
BACKGROUND: The Spectrum and Estimation and Projection Package (EPP) programs are used to estimate key HIV indicators based on HIV surveillance and surveys, programme statistics and epidemic patterns. These indicators include the number of people living with HIV, new infections, AIDS deaths, AIDS orphans, the number of adults and children needing treatment, the need for preventing mother to child transmission (PMTCT) and the impact of antiretroviral treatment on survival. METHODS: The Joint United Nations Programme on HIV and AIDS (UNAIDS) Reference Group on Estimates, Models and Projections regularly reviews new data and information needs and recommends updates to the methodology and assumptions used in Spectrum. The latest updates described here were used in the 2011 round of global estimates. RESULTS: Spectrum and EPP have now been combined into one software package to enhance ease of use and ensure consistent data and assumptions for the curve fitting and indicator estimations. Major enhancements to the methods include a new adult model that tracks the HIV+ population by CD4 count; new patterns describing child survival by time of infection (perinatally, <6 months, 7-12 months and 12+ months after birth); a more detailed estimate of mother-to-child transmission that includes differential transmission rates by CD4 count of the mother, the effects of incident infections and new prophylaxis options; and new procedures to estimate uncertainty ranges around regional estimates. CONCLUSIONS: The revised model and software facilitate the preparation of new HIV estimates and use new data to address emerging needs for better information on need for treatment among adults and children.
背景:Spectrum 和 Estimation and Projection Package(EPP)程序用于根据 HIV 监测和调查、规划统计数据和流行模式来估计关键的 HIV 指标。这些指标包括:HIV 感染者人数、新感染人数、艾滋病死亡人数、艾滋病孤儿人数、需要治疗的成年人和儿童人数、预防母婴传播(PMTCT)的需求以及抗逆转录病毒治疗对生存率的影响。
方法:联合国艾滋病规划署(UNAIDS)估计、模型和预测参考小组定期审查新数据和信息需求,并建议更新 Spectrum 中使用的方法和假设。这里描述的最新更新用于 2011 年全球估计数的一轮计算。
结果:Spectrum 和 EPP 现在已合并为一个软件包,以增强易用性并确保曲线拟合和指标估计的数据和假设保持一致。方法的主要改进包括一个新的成人模型,该模型通过 CD4 计数跟踪 HIV+人群;描述按感染时间(围产期、<6 个月、7-12 个月和 12 个月后)的儿童生存新模式;更详细的母婴传播估计,包括按母亲 CD4 计数、新发感染的影响和新的预防选择的差异传播率;以及用于估计区域估计数的不确定性范围的新程序。
结论:修订后的模型和软件有助于编制新的 HIV 估计数,并利用新数据满足更好地了解成人和儿童治疗需求的新需求。
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