The epidemiology of HIV/AIDS and the use of antiretroviral therapy in Korea: a narrative review

Abstract

The availability of combined antiretroviral therapy has significantly reduced the number of new HIV infections and the associated mortality, and HIV infection has become a chronic disease with long-term survival. In Korea, more than 1,000 new HIV infections have been registered annually since 2013. After peaking at 1,223 in 2019, the number of new infections decreased between 2020 and 2023. In 2023, the majority of newly HIV-infected people were men, and the proportions of young people under 40 years, homosexual contacts and foreigners increased. Acquired immunodeficiency syndrome (AIDS)-related deaths from opportunistic infections associated with immunosuppression and AIDS-defining cancers are gradually decreasing, whereas non-AIDS defining comorbidities such as non-AIDS defining cancers, cardiovascular disease and metabolic complications are emerging as major causes of death. Since the introduction of zidovudine, approximately 30 antiretroviral drugs have been approved for the treatment of HIV infection. Early and continuous antiretroviral treatment for all people living with HIV is an effective strategy for maintaining viral suppression and preventing transmission of HIV infection. In conclusion, achieving the 95–95–95 target among those living with HIV in Korea requires multifaceted efforts to improve early diagnosis, early and proper treatment of HIV infection including the management of chronic diseases, and adherence to antiretroviral therapy.