Cohort Profile: Antiretroviral Therapy Cohort Collaboration (ART-CC)

Abstract

The advent of effective combination antiretroviral therapy (ART) in 1996 resulted in fewer patients experiencing clinical events, so that some prognostic analyses of individual cohort studies of human immunodeficiency virus-infected individuals had low statistical power. Because of this, the Antiretroviral Therapy Cohort Collaboration (ART-CC) of HIV cohort studies in Europe and North America was established in 2000, with the aim of studying the prognosis for clinical events in acquired immune deficiency syndrome (AIDS) and the mortality of adult patients treated for HIV-1 infection. In 2002, the ART-CC collected data on more than 12,000 patients in 13 cohorts who had begun combination ART between 1995 and 2001. Subsequent updates took place in 2004, 2006, 2008, and 2010. The ART-CC data base now includes data on more than 70,000 patients participating in 19 cohorts who began treatment before the end of 2009. Data are collected on patient demographics (e.g. sex, age, assumed transmission group, race/ethnicity, geographical origin), HIV biomarkers (e.g. CD4 cell count, plasma viral load of HIV-1), ART regimen, dates and types of AIDS events, and dates and causes of death. In recent years, additional data on co-infections such as hepatitis C; risk factors such as smoking, alcohol and drug use; non-HIV biomarkers such as haemoglobin and liver enzymes; and adherence to ART have been collected whenever available. The data remain the property of the contributing cohorts, whose representatives manage the ART-CC via the steering committee of the Collaboration. External collaboration is welcomed. Details of contacts are given on the ART-CC website (www.art-cohort-collaboration.org).

The effects of HIV-1 subtype and ethnicity on the rate of CD4 cell count decline in patients naive to antiretroviral therapy: a Canadian-European collaborative retrospective cohort study

“…[18][19][20][21][22][23] The project was approved by the relevant scientific boards or steering committees. EuroSIDA omitted patients also enrolled in other contributing cohorts.…”

Sex Differences in Overall and Cause-Specific Mortality among HIV-Infected Adults on Antiretroviral Therapy in Europe, Canada and the US

“…Mortality rates in the North American cohorts were higher than for European cohorts, both for the women and for the men. The ART Collaboration has recently described how this heterogeneity is partially due to lower losses to follow-up rates, higher death ascertainment and differential inclusion criteria of very socially deprived HIV-positive patients in cohorts from North-America (31). This, however, should not be different for the men and the women and would not bias our results.…”

“…Details of the collaboration appear elsewhere [18][19] (http://www.art-cohortcollaboration.org). Briefly, it includes patients with confirmed HIV infection, aged ≥16 years who started cART (a combination of at least 2 nucleoside reverse transcriptase inhibitors plus boosted protease inhibitor (PI) or non-nucleoside reverse transcriptase inhibitor) after 1st January 1998.…”

Structure and quality of outpatient care for people living with an HIV infection

“…Existing cohort studies may create opportunities to expand this research field. In Europe for example, there are multiple cohort studies (Mary-Krause et al, 2014;Omland, Ahlstrom, & Obel, 2014;Schoeni-Affolter et al, 2010;van Sighem, Smit, Stolte, & Reiss, 2014), some of which participate in collaborations with other cohort studies (Bohlius et al, 2009;May et al, 2014). The collected data can be an excellent source for retrospective research into the impact of health facility characteristics (such as facility volume) on health outcomes.…”