The creation of a large UK‐based multicentre cohort of HIV‐infected individuals: The UK Collaborative HIV Cohort (UK CHIC) Study

Sabin, Caroline; Babiker, Abdel; Dunn, David; Easterbrook, P; Fisher, Martin; Gilson, Richard; Johnson, Margaret; Mortimer, Janet; Peters, Barry; Phillips, Andrew; Porter, Kholoud; Scullard, George; Gazzard, Brian; Matthias, Ryanne; Hill, Teresa; Cohort, UK Collaborative Hiv

doi:10.1111/j.1468-1293.2004.00197.x

Cited by 134 publications

(49 citation statements)

References 13 publications

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“…The first sequence available for each patient was analyzed. Fully anonymized clinical data corresponding to many of the sequences was made available by the UK Clinical HIV Cohort (UK CHIC) [64], with viral load before starting ART being available for 8,700 initial subtype B sequences, reflecting the most prevalent subtype epidemic in the UK. The data used were the most current available, with sequences and clinical data collected up to mid-2009.…”

Section: Resultsmentioning

confidence: 99%

The Contribution of Viral Genotype to Plasma Viral Set-Point in HIV Infection

et al. 2014

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Disease progression in HIV-infected individuals varies greatly, and while the environmental and host factors influencing this variation have been widely investigated, the viral contribution to variation in set-point viral load, a predictor of disease progression, is less clear. Previous studies, using transmission-pairs and analysis of phylogenetic signal in small numbers of individuals, have produced a wide range of viral genetic effect estimates. Here we present a novel application of a population-scale method based in quantitative genetics to estimate the viral genetic effect on set-point viral load in the UK subtype B HIV-1 epidemic, based on a very large data set. Analyzing the initial viral load and associated pol sequence, both taken before anti-retroviral therapy, of 8,483 patients, we estimate the proportion of variance in viral load explained by viral genetic effects to be 5.7% (CI 2.8–8.6%). We also estimated the change in viral load over time due to selection on the virus and environmental effects to be a decline of 0.05 log10 copies/mL/year, in contrast to recent studies which suggested a reported small increase in viral load over the last 20 years might be due to evolutionary changes in the virus. Our results suggest that in the UK epidemic, subtype B has a small but significant viral genetic effect on viral load. By allowing the analysis of large sample sizes, we expect our approach to be applicable to the estimation of the genetic contribution to traits in many organisms.

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Section: Resultsmentioning

confidence: 99%

The Contribution of Viral Genotype to Plasma Viral Set-Point in HIV Infection

et al. 2014

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“…Data were obtained from the United Kingdom Collaborative HIV Cohort (UK CHIC) Study, which collates routinely collected data on HIV-positive individuals >16 years age from several of the largest HIV clinics in the United Kingdom [26]. The study was approved by a multicenter research ethics committee and by local ethics committees and does not require informed consent.…”

Section: Methodsmentioning

confidence: 99%

Incomplete Reversibility of Estimated Glomerular Filtration Rate Decline Following Tenofovir Disoproxil Fumarate Exposure

José

Hamzah

Campbell

et al. 2014

The Journal of Infectious Diseases

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Background. Tenofovir disoproxil fumarate (TDF) has been linked to renal impairment, but the extent to which this impairment is reversible is unclear. We aimed to investigate the reversibility of renal decline during TDF therapy.Methods. Cox proportional hazards models assessed factors associated with discontinuing TDF in those with an exposure duration of >6 months. In those who discontinued TDF therapy, linear piecewise regression models estimated glomerular filtration rate (eGFR) slopes before initiation of, during, and after discontinuation of TDF therapy. Factors associated with not achieving eGFR recovery 6 months after discontinuing TDF were assessed using multivariable logistic regression.Results. We observed declines in the eGFR during TDF exposure (mean slopes, −15.7 mL/minute/1.73 m2/year [95% confidence interval {CI}, −20.5 to −10.9] during the first 3 months and −3.1 mL/minute/1.73 m2/year [95% CI, −4.6 to −1.7] thereafter) and evidence of eGFR increases following discontinuation of TDF therapy (mean slopes, 12.5 mL/minute/1.73 m2/year [95% CI, 8.9–16.1] during the first 3 months and 0.8 mL/minute/1.73 m2/year [95% CI, .1–1.5] thereafter). Following TDF discontinuation, 38.6% of patients with a decline in the eGFR did not experience recovery. A higher eGFR at baseline, a lower eGFR after discontinuation of TDF therapy, and more-prolonged exposure to TDF were associated with an increased risk of incomplete recovery 6 months after discontinuation of TDF therapy.Conclusions. This study shows that a decline in the eGFR during TDF therapy was not fully reversible in one third of patients and suggests that prolonged TDF exposure at a low eGFR should be avoided.

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“…We used data from the UK Collaborative HIV Cohort (UK CHIC) study 11 to compare the proportions of people with an undetectable VL at 1 year after starting ART between UK HIV treatment centres. After investigating differences in case mix between the centres, we used funnel plots to describe the differences in this performance measure between centres and to visually illustrate the impact of case mix on the interpretation of results from these analyses.…”

Section: Introductionmentioning

confidence: 99%

The use of funnel plots with regression as a tool to visually compare HIV treatment outcomes between centres adjusting for patient characteristics and size: a UK Collaborative HIV Cohort study

et al. 2018

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ObjectivesA measure used for assessing the effectiveness of HIV care and comparing clinical centres is the proportion of people starting antiretroviral therapy (ART) with viral suppression (VS) after 1 year. We propose a method that adjusts for patients’ demographic characteristics, and visually compares this measure between different sites accounting for centre size.MethodsWe analysed viral load measurements for UK Collaborative HIV Cohort (UK CHIC) patients starting ART between 2006 and 2013. We used logistic regression to estimate the proportion with VS after 1 year of ART adjusted for patient mix (in terms of age and a combined gender/ethnicity/acquisition mode variable) and calendar year. We compared outcomes between centres using funnel plots which account for centre size.ResultsThe overall proportion of the cohort with VS 1 year after starting ART was 90% and increased from 83% to 93% between 2006 and 2013. VS was lower in younger individuals. White men who have sex with men (MSM) had the highest (94%), and black African (81%) and white (82%) heterosexual women the lowest proportions achieving VS. Comparing the unadjusted funnel plot with the adjusted, there were movements of some centres from outside to inside the 95% contour limits, which was largely explained by the patient mix of these centres.Conclusions VS 1 year after ART start was associated with demographic characteristics and centre size; therefore, to compare the performances of centres, adjustment for these factors is required. Adjusted funnel plot is an effective tool which accounts for both the demographic characteristics and the centre size. Social factors, rather than treatment decisions within the control of the centres, may drive differences in outcomes.

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The creation of a large UK‐based multicentre cohort of HIV‐infected individuals: The UK Collaborative HIV Cohort (UK CHIC) Study

Abstract: The UK CHIC Study provides important information on the status of individuals infected with HIV in the UK, and provides a means to study the response to HAART and to monitor changes in the clinical event and death rates that have occurred since the introduction of HAART in the UK.

Cited by 134 publications

References 13 publications

The Contribution of Viral Genotype to Plasma Viral Set-Point in HIV Infection

The Contribution of Viral Genotype to Plasma Viral Set-Point in HIV Infection

Incomplete Reversibility of Estimated Glomerular Filtration Rate Decline Following Tenofovir Disoproxil Fumarate Exposure

The use of funnel plots with regression as a tool to visually compare HIV treatment outcomes between centres adjusting for patient characteristics and size: a UK Collaborative HIV Cohort study

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