The Approaches To Fully Grasp AZD6244 Plus The Way One Can Be Part Of The AZD6244 Top Dogs

4 million were newly infected.1 To prevent HIV transmission and help those who live with HIV to have access to care and treatment in due time, the consensus today is that individuals should be diagnosed as early as possible in the course of HIV infection, that is to say, before eligibility criteria for antiretroviral therapy (ART) initiation are met. Once an buy AZD6244 individual is diagnosed HIV positive, there are several steps up to ART initiation, known as the HIV cascade:2�C4 (1) from HIV diagnosis to linkage to HIV care, (2) from linkage to HIV care to ART eligibility, (3) from ART eligibility to ART initiation. Continuum in HIV care through these different steps is critical for individuals to receive adequate clinical and biological monitoring, and to initiate ART immediately on becoming eligible in order to minimise early morbidity and mortality. It has indeed been shown that people who engaged in HIV care prior to eligibility were more likely to initiate and remain on ART than those entering in care when already eligible,5 6 and that the risk of mortality was reduced if ART was initiated early enough in the course of HIV infection.7 Finally, being in pre-ART care for more than 6?months was significantly associated with reduced rates of mortality and loss to follow-up after starting ART.8 In sub-Saharan Africa, many people are lost to follow-up between HIV diagnosis and ART initiation and these individuals are thus at risk of delayed ART initiation.9 Although the 2013 WHO recommendations for initiating ART reduce the length of time before reaching ART eligibility,10 ART eligibility criteria in most African countries are based on a CD4 to expand their ART eligibility criteria and translate the WHO recommendation into practice. In the evolving context where many interventions are developed, evaluated and implemented with the aim of increasing the uptake of HIV testing among people early in the course of HIV infection,11 retention in care prior to ART eligibility is a key issue that needs to be better understood. Three literature reviews have been conducted on HIV care prior to ART initiation in recent years,2�C4 but they mostly focused on linkage to care and provided very little information on retention in HIV care prior to ART eligibility as well as on risk factors for retention. In this paper, we have thus focused on this second step of the HIV cascade. We specifically aimed at summarising the scientific knowledge on retention in care prior to ART eligibility (definition, rates and risk factors) among adults in sub-Saharan Africa. Methods Data source and search strategy We conducted a systematic literature review on retention in HIV care prior to ART eligibility in sub-Saharan Africa searching MEDLINE/PubMed, Scopus (which contains EMBASE references) and Web of Science until 21 January 2014.