Life expectancy of <scp>HIV</scp>‐positive people after starting combination antiretroviral therapy: a meta‐analysis

Teeraananchai, Sirinya; Kerr, Stephen J.; Amin, Janaki; Ruxrungtham, Kiat; Law, Matthew

doi:10.1111/hiv.12421

Cited by 331 publications

(233 citation statements)

References 29 publications

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“…HIV has long been viewed as an exceptional disease by policy makers and clinicians, and this exceptionalism meant that early in the epidemic, HIVST was banned in many countries, due to concerns over the potential for self-harm in the absence of effective treatments and the potential for coercive use (11). In recent years, the shift in HIV to a chronic manageable disease with near normal life expectancy (12,13) …”

Section: Regulatory Approval and Policymentioning

confidence: 99%

New initiatives to develop self-testing for HIV

Witzel

Rodger

2017

Current Opinion in Infectious Diseases

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Purpose of the review: The purpose is to describe the most recent literature associated with HIV self -testing (HIVST). Recent findings:HIVST is acceptable to a range of populations in a variety of contexts, particularly if users values and preferences are taken into account in intervention development. Approaches being explored in on-going and planned studies are the efficacy of HIVST to increase diagnosis of longstanding prevalent infections and to reduce the interval between HIV transmission and diagnosis, particularly in high incidence groups. Though there is little evidence of harms related to HIVST, this remains a potential issue. Concerns remain about the reliability of currently available HIVST kits, which have lower sensitivity than testing options available in clinical settings, particularly in early HIV infection. Evidence on linkage to care for confirmatory testing after a reactive HIVST result and the cost effectiveness of HIVST to increase rates of HIV diagnosis is currently limited. Summary:HIVST is relatively new innovation that appears acceptible to key populations and which could increase HIV testing rates and rates of HIV diagnosis especially in at-risk groups. Concerns

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Section: Regulatory Approval and Policymentioning

confidence: 99%

New initiatives to develop self-testing for HIV

Witzel

Rodger

2017

Current Opinion in Infectious Diseases

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“…Despite tremendous advances in the effectiveness of ART and increases in patient access to ART over the last two decades [1, 66, 67], virologic suppression with ART is often not sufficient to fully ameliorate the heightened immune activation present with HIV infection, especially among those who fail to restore CD4+ T cell counts [29, 32, 34]. Continued immune activation in HIV-infected persons on ART is likely the result of several mechanisms.…”

Section: Introductionmentioning

confidence: 99%

Inflammation, Immune Activation, and Antiretroviral Therapy in HIV

2017

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Purpose of Review This review focuses on the differential effects of contemporary antiretrovirals on systemic inflammation as heightened immune activation is linked to important co-morbidities and mortality with HIV infection. Recent Findings Antiretroviral therapy (ART) reduces dramatically systemic inflammation and immune activation, but not to levels synchronous with HIV-uninfected populations. In one ART initiation trial, integrase inhibitors appear to reduce inflammation to a greater degree than non-nucleoside reverse transcriptase inhibitors (NNRTIs); however, it is not clear that there are beneficial effects on inflammation resulting from treatment with integrase inhibitors compared to PIs, between PIs and NNRTIs, between specific nucleoside reverse transcriptase inhibitors, or with maraviroc in ART-naïve patients. In ART switch studies, changing to an integrase inhibitor from a PI-, NNRTI-, or enfuvirtide-containing regimen has resulted in improvement in several markers of inflammation. Summary Additional research is needed to conclusively state whether there are clear differences in effects of specific antiretrovirals on inflammation and immune activation in HIV.

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“…1 In 2017, HIV is best viewed through the public health lens as a chronic disease associated with unique clinical issues.…”

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confidence: 99%

Cancer screening in women living with HIV infection

Aboulafia

2017

Womens Health (Lond Engl)

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The number of women living with HIV continues to increase. Thirty years into the AIDS epidemic, we now expect those with access to highly active antiretroviral to survive into their seventh decade of life or beyond. Increasingly, the focus of HIV care is evolving from preventing opportunistic infections and treating AIDS-defining malignancies to strategies that promote longevity. This holistic approach to care includes detection of malignancies that are associated with certain viral infections, with chronic inflammation, and with lifestyle choices. The decision to screen an HIV-infected women for cancer should include an appreciation of the individualized risk of cancer, her life expectancy, and an attempt to balance these concerns with the harms and benefits associated with specific cancer screening tests and their potential outcome. Here, we review cancer screening strategies for women living with HIV/AIDS with a focus on cancers of the lung, breast, cervix, anus, and liver.

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Life expectancy of HIV‐positive people after starting combination antiretroviral therapy: a meta‐analysis

Abstract: Our results suggest that the life expectancy of HIV-positive people after starting cART has improved over time. Monitoring life expectancy into the future is important to assess how changes to cART guidelines will affect patient long-term outcomes.

Cited by 331 publications

References 29 publications

New initiatives to develop self-testing for HIV

New initiatives to develop self-testing for HIV

Inflammation, Immune Activation, and Antiretroviral Therapy in HIV

Cancer screening in women living with HIV infection

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