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CDC HIV/AIDS/Viral Hepatitis/STD/TB Prevention News Update
AUSTRALIA: The Burden of HIV-Associated Neurocognitive Impairment in Australia and Its Estimates for the Future
Lucette A. Cysique; Margaret P. Bain; Bruce J. Brew; John M.
February 28, 2012
Sexual Health Vol. 8; No. 4: P. 541-550 (11..11) - Tuesday,

"The growing number of older individuals with HIV in Australia implies that the prevalence of dementia and additional HIV- associated neurocognitive disorders will increase," wrote the authors, who commented on the lack of estimates "of the future burden of neurocognitive disease in this population." Using data from the HIV/AIDS Registry, the team estimated the number and age profile of people living with HIV to the end of 2009, then extrapolated these estimates to 2030. The future burden of HIV-associated dementia was estimated based on the prevalence of HAD from 2005 to 2010 in a large Sydney hospital, and cost estimates from the AIDS Dementia and HIV Psychiatry Service were used to estimate future costs.

The authors' calculations suggest that the number of Australians with HIV will increase from 16,228 men and 1,797 women in 2009 to 26,963 men and 5,224 women in 2030. The numbers of these individuals age 60 and older are expected to increase from 1,140 men and 78 women to 5,442 men (a 377 percent increase) and 721 women (an 825 percent increase).

"Based on a 7.8 percent (157/2,004) HAD prevalence obtained from hospital data, individuals with HAD will increase in number from 1,314 men and 143 women in 2009 to 2,204 men and 421 women in 2030," the authors reported. The estimated 22 men and two women with non-HIV dementia in 2009 is predicted to increase to 104 men and 12 women by 2030. Annual cost of care is forecast to rise from approximately $29 million (US $31 million) in 2009 to $53 million (US $56.7 million) in 2030, chiefly for full-time residential care.

"Neurocognitive disorders will place an increasing burden on resources, especially as those living with HIV age," the authors concluded. "Because it is unclear if HAD is an increased risk factor for non-HIV dementia, our calculations may be conservative."

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