Longitudinal community plasma HIV-1 RNA concentrations and incidence of HIV-1 among injecting drug users: prospective cohort study

Wood, Evan; Kerr, Thomas; Marshall, Brandon D.L.; Li, Kathy; Zhang, Ruth; Hogg, Robert S.; Harrigan, P. Richard; Montaner, Julio S. G.

doi:10.1136/bmj.b1649

Cited by 313 publications

(282 citation statements)

References 32 publications

(42 reference statements)

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“…HIV treatment with ARV therapy can substantially decrease morbidity and mortality and reduce the rate of HIV transmission. [33][34][35][36][37][38][39][40] Approximately 16.9% of all HIV-positive individuals are in the U.S. criminal justice system 41 ; therefore, interventions that improve ARV uptake, as well as ARV adherence and persistence after release from jails and prisons have the potential to curtail the HIV epidemic by decreasing HIV transmission to others. This is particularly relevant given the deleterious effect of short-term incarceration and release on virologic outcomes [42][43][44] and the high frequency of self-reported HIV-related risky behaviors of newly released HIV-positive inmates.…”

Section: Discussionmentioning

confidence: 99%

Directly Observed versus Self-administered Antiretroviral Therapies: Preference of HIV-Positive Jailed Inmates in San Francisco

et al. 2012

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Directly observed therapy (DOT) of antiretroviral (ARV) medications has beneficial effects on HIV treatment for incarcerated inmates but has been associated with limited continuation after release and inadvertent disclosure of HIV status. Guided self-administered therapy (g-SAT) may be a preferred method of ARV delivery and may encourage medication-taking behavior. We surveyed the preference of 102 HIV-positive jailed inmates at the San Francisco City and County Jails regarding receiving ARVs via DOT versus g-SAT while incarcerated. Participants overwhelmingly preferred g-SAT over DOT.

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Section: Discussionmentioning

confidence: 99%

Directly Observed versus Self-administered Antiretroviral Therapies: Preference of HIV-Positive Jailed Inmates in San Francisco

et al. 2012

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“…This trend appeared robust in different models of cohort analyses, was not explained by design limitations of open cohort studies, and was only partially explained by changing co-factors such as new drugs or improved adherence over time. The finding that the proportion of HIV-infected persons with stably suppressed viral load at the population level has been increasing to such levels may have further implications for HIV prevention [16] and should encourage efforts to implement widespread test-and-treat programmes [17], also in developing countries.…”

Section: Trends In Effectiveness Of Antiretroviral Therapy 285mentioning

confidence: 99%

Trends over time of virological and immunological characteristics in the Swiss HIV Cohort Study*

Ledergerber¹,

Cavassini²,

Battegay³

et al. 2010

HIV Medicine

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The long-term outcome of antiretroviral therapy (ART) is not assessed in controlled trials. We aimed to analyse trends in the population effectiveness of ART in the Swiss HIV Cohort Study over the last decade. MethodsWe analysed the odds of stably suppressed viral load (ssVL: three consecutive values o50 HIV-1 RNA copies/mL) and of CD4 cell count exceeding 500 cells/mL for each year between 2000 and 2008 in three scenarios: an open cohort; a closed cohort ignoring the influx of new participants after 2000; and a worst-case closed cohort retaining lost or dead patients as virological failures in subsequent years. We used generalized estimating equations with sex, age, risk, non-White ethnicity and era of starting combination ART (cART) as fixed co-factors. Time-updated co-factors included type of ART regimen, number of new drugs and adherence to therapy. ResultsThe open cohort included 9802 individuals (median age 38 years; 31% female). From 2000 to 2008, the proportion of participants with ssVL increased from 37 to 64% [adjusted odds ratio (OR) per year 1.16 (95% CI 1.15-1.17)] and the proportion with CD4 count 4500 cells/mL increased from 40 to 450% [OR 1.07 (95% CI 1.06-1.07)]. Similar trends were seen in the two closed cohorts. Adjustment did not substantially affect time trends. ConclusionsThere was no relevant dilution effect through new participants entering the open clinical cohort, and the increase in virological/immunological success over time was not an artefact of the study design of open cohorts. This can partly be explained by new treatment options and other improvements in medical care.

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“…Julio Montaner, director of the British Columbia Centre for Excellence in HIV/AIDS, described similar results last year for a study of intravenous drug users in Vancouver 3 .…”

mentioning

confidence: 69%

'Seek, test and treat' slows HIV

Hayden¹

2010

Nature

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Longitudinal community plasma HIV-1 RNA concentrations and incidence of HIV-1 among injecting drug users: prospective cohort study

Abstract: Objective To examine the relation between plasma HIV-1

Cited by 313 publications

References 32 publications

Directly Observed versus Self-administered Antiretroviral Therapies: Preference of HIV-Positive Jailed Inmates in San Francisco

Directly Observed versus Self-administered Antiretroviral Therapies: Preference of HIV-Positive Jailed Inmates in San Francisco

Trends over time of virological and immunological characteristics in the Swiss HIV Cohort Study*

'Seek, test and treat' slows HIV

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