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London – Within the next 25 years, AIDS is set to join heart disease and stroke as the top three causes of death worldwide, according to a study published online Monday.

When global mortality projections were last calculated a decade ago, researchers had assumed the number of AIDS cases would be declining; instead, they’re rising.

Currently ranked fourth behind heart disease, stroke and respiratory infections, AIDS is set to become No. 3, say researchers in a new report in the Public Library of Science’s Medicine journal. AIDS accounts for about 2.8 million deaths every year, but the researchers estimate a total of nearly 120 million people could die in the next 25 years.

Overall, the researchers predict that in three decades, the causes of global mortality will be strikingly similar worldwide – apart from the prevalence of AIDS in poorer countries. Most people will be dying at older ages of noninfectious diseases such as cardiovascular disease, stroke and cancer.

The paper by Dr. Colin Mathers and Dejan Loncar of the World Health Organization estimates that at least 117 million people will die from AIDS from 2006 to 2030. In an optimistic future projection, if new HIV infections are curbed and access to life-prolonging antiretrovirals is increased, 89 million people will die from the disease.

“What happens in the future depends very much on what the international community does now,” Mathers said.

These marked differences should spark changes in current approaches to controlling AIDS now, say some experts.

“It will be increasingly hard to sustain treatment programs unless we can turn off the tap of new HIV infections,” said Dr. Richard Hays, professor of epidemiology at London’s School of Hygiene and Tropical Medicine, who was not linked to the study. “These AIDS numbers point to a need to do more in prevention.”

Mathers and Loncar analyzed data from more than 100 countries.

The authors looked at the links between mortality trends and income per capita as well as factors including education levels and tobacco use. Their research also used U.N. estimates for projected AIDS infection rates and the World Bank’s numbers for future income per capita.

Mathers and Loncar then took all of this information and plugged it into a complex modeling equation to predict the top future causes of death and disease.

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