Trends and Differences among Three New Indicators of HIV Infection Progression

Abstract

Objective. This study proposes three indicators of, and assesses the disparities and trends in, the risk of HIV infection progression among people living with diagnosed HIV infection in the United States.Methods. Using data reported to national HIV surveillance through June 2012, we calculated the AIDS diagnosis hazard, HIV (including AIDS) death hazard, and AIDS death hazard for people living with diagnosed HIV infection for each calendar year from 1997 to 2010. We also calculated a stratified hazard in 2010 by age, race/ethnicity, mode of transmission, region of residence at diagnosis, and year of diagnosis.Results. The risk of HIV infection progression among people living with diagnosed HIV infection decreased significantly from 1997 to 2010. The risks of progression to AIDS and death in 2010 were higher among African Americans and people of multiple races, males exposed through injection drug use (IDU) or heterosexual contact, females exposed through IDU, people residing in the South at diagnosis, and people diagnosed in 2009 compared with white individuals, men who have sex with men, females with infection attributed to heterosexual contact, those residing in the Northeast, and those diagnosed in previous years, respectively. People aged 15-29 years had the highest AIDS diagnosis hazard in 2010.Conclusion. Continued efforts are needed to ensure early HIV diagnosis as well as initial linkage to and continued engagement in HIV medical care among all people living with HIV. Targeted interventions are needed to improve healthcare and supportive services for those with worse health outcomes.

Impact of Heroin and HIV on Gut Integrity and Immune Activation

“…People with HIV (PWH) whose mode of HIV acquisition was intravenous drug use are at higher risk of progression to AIDS, death due to AIDS, and all-cause mortality even when controlling for access to care and antiretroviral therapy (ART) duration. [1][2][3][4] Although high-risk lifestyle or death from comorbid conditions, such as bacterial infection or hepatitis C, certainly contribute, chronic immune activation may play an important role. In an observational study of people with a history of injecting drugs, an inflammatory index constructed from serum interleukin (IL)-6 and soluble tumor necrosis factor-a-receptor I (sTNF-a-RI) was associated with frailty and increased mortality in PWH and people without HIV who inject drugs.…”

The factors associated with natural disease progression from HIV to AIDS in the absence of ART, a propensity score matching analysis

“…Simultaneously, HIV testing motivated by symptoms would cause a late diagnosis for HIV-infected individuals. Further results of previous studies also showed that those diagnosed at medical institutions were at higher risk of late-stage diagnosis of HIV compared with other sample sources [38]. Moreover, it is possible that the HIV-infected individuals who participated in the unique survey received early access to diagnosis, treatment and support, and HIV care.…”