AIDS (London, England)最新文献_第8页

Mortality of treated HIV-1 positive individuals according to viral subtype in Europe and Canada: collaborative cohort analysis 欧洲和加拿大根据病毒亚型治疗的HIV-1阳性个体的死亡率:合作队列分析

AIDS (London, England) Pub Date : 2016-01-13 DOI: 10.1097/QAD.0000000000000941

M. May, M. Gill, L. Wittkop, M. Klein, Caroline Sabin, P. Harrigan, David Dunn, J. J. Vehreschild, Rafael Rubio, A. Mocroft, M. Cavassini, P. Reiss, A. Monforte, R. Zangerle, Suzanne M Ingle, T. Hill, S. Jose, J. Sterne

{"title":"Mortality of treated HIV-1 positive individuals according to viral subtype in Europe and Canada: collaborative cohort analysis","authors":"M. May, M. Gill, L. Wittkop, M. Klein, Caroline Sabin, P. Harrigan, David Dunn, J. J. Vehreschild, Rafael Rubio, A. Mocroft, M. Cavassini, P. Reiss, A. Monforte, R. Zangerle, Suzanne M Ingle, T. Hill, S. Jose, J. Sterne","doi":"10.1097/QAD.0000000000000941","DOIUrl":"https://doi.org/10.1097/QAD.0000000000000941","url":null,"abstract":"Objectives:To estimate prognosis by viral subtype in HIV-1-infected individuals from start of antiretroviral therapy (ART) and after viral failure. Design:Collaborative analysis of data from eight European and three Canadian cohorts. Methods:Adults (N>20 000) who started triple ART between 1996 and 2012 and had data on viral subtype were followed for mortality. We estimated crude and adjusted (for age, sex, regimen, CD4+ cell count, and AIDS at baseline, period of starting ART, stratified by cohort, region of origin and risk group) mortality hazard ratios (MHR) by subtype. We estimated MHR subsequent to viral failure defined as two HIV-RNA measurements greater than 500 copies/ml after achieving viral suppression. Results:The most prevalent subtypes were B (15 419; 74%), C (2091; 10%), CRF02AG (1057; 5%), A (873; 4%), CRF01AE (506; 2.4%), G (359; 1.7%), and D (232; 1.1%). Subtypes were strongly patterned by region of origin and risk group. During 104 649 person-years of observation, 1172/20 784 patients died. Compared with subtype B, mortality was higher for subtype A, but similar for all other subtypes. MHR for A versus B were 1.13 (95% confidence interval 0.85,1.50) when stratified by cohort, increased to 1.78 (1.27,2.51) on stratification by region and risk, and attenuated to 1.59 (1.14,2.23) on adjustment for covariates. MHR for A versus B was 2.65 (1.64,4.28) and 0.95 (0.57,1.57) for patients who started ART with CD4+ cell count below, or more than, 100 cells/&mgr;l, respectively. There was no difference in mortality between subtypes A, B and C after viral failure. Conclusion:Patients with subtype A had worse prognosis, an observation which may be confounded by socio-demographic factors.","PeriodicalId":355297,"journal":{"name":"AIDS (London, England)","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117241869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 8

Dosing antiretroviral medication when crossing time zones: a review 跨时区服用抗逆转录病毒药物:综述

AIDS (London, England) Pub Date : 2016-01-01 DOI: 10.1097/QAD.0000000000000920

J. Lewis, A. Volny-Anne, C. Waitt, M. Boffito, S. Khoo

引用次数: 9

Kenyan MSM: no longer a hidden population 肯尼亚男同性恋者:不再是隐藏的人群

AIDS (London, England) Pub Date : 2015-12-01 DOI: 10.1097/QAD.0000000000000928

E. Sanders, H. Jaffe, H. Musyoki, Nicolas Muraguri, S. Graham

引用次数: 19

Heterosexual behaviours among men who sell sex to men in coastal Kenya 肯尼亚沿海地区男同性恋者的异性恋行为

AIDS (London, England) Pub Date : 2015-12-01 DOI: 10.1097/QAD.0000000000000889

A. Smith, Allan Muhaari, Carole Agwanda, D. Kowuor, Elise M van der Elst, Alun H. Davies, S. Graham, H. Jaffe, E. Sanders

{"title":"Heterosexual behaviours among men who sell sex to men in coastal Kenya","authors":"A. Smith, Allan Muhaari, Carole Agwanda, D. Kowuor, Elise M van der Elst, Alun H. Davies, S. Graham, H. Jaffe, E. Sanders","doi":"10.1097/QAD.0000000000000889","DOIUrl":"https://doi.org/10.1097/QAD.0000000000000889","url":null,"abstract":"Objective:African men who have sex with men often sell sex to men, and MSM who sell sex (MSM-SW) often also have female partners. We compared sexual risk behaviour of MSM-SW who were sexually active with female partners (bisexual MSW) to MSM-SW with only male partners (exclusive MSW). Design:Descriptive behavioural study Methods:A novel, validated daily event and partner diary self-completed by 82 MSM who sold sex over a follow-up period of 42 days with weekly review. Cumulative individual counts of sex and condomless sex were compiled by partner characteristics. The incidence of specific partnerships and sex acts were compared within and between bisexual and exclusive MSW. Results:Most (59%) MSM-SW reported female partners during follow-up. The majority of both male and female partners were cash-paying clients originating locally. Bisexual MSW reported a similar rate of condomless sex with male and female partners, but significantly fewer male partners than exclusive MSW. Bisexual MSW had lower HIV prevalence, were more likely to only report insertive anal sex roles, and reported lower frequencies of condomless receptive anal sex than exclusive MSW. Conclusion:Bisexually active male sex workers in coastal Kenya create HIV and other sexually transmitted infection transmission pathways to partners and clients in both MSM and heterosexual networks, but differed from exclusive MSW in having lower HIV acquisition and transmission risks. Epidemiological projection methods are liable to overestimate bridging potential of MSM-SW and MSM populations without account for systematic differences in risk within these populations.","PeriodicalId":355297,"journal":{"name":"AIDS (London, England)","volume":"181 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132252696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 23

Trends and determinants of survival for over 200 000 patients on antiretroviral treatment in the Botswana National Program: 2002–2013 博茨瓦纳国家规划中接受抗逆转录病毒治疗的20多万患者的趋势和生存决定因素:2002-2013年

AIDS (London, England) Pub Date : 2015-12-01 DOI: 10.1097/QAD.0000000000000921

M. Farahani, Natalie Price, S. el-Halabi, Naledi Mlaudzi, K. Keapoletswe, R. Lebelonyane, E. Fetogang, Tony Chebani, P. Kebaabetswe, T. Masupe, Keba Gabaake, A. Auld, O. Nkomazana, R. Marlink

{"title":"Trends and determinants of survival for over 200 000 patients on antiretroviral treatment in the Botswana National Program: 2002–2013","authors":"M. Farahani, Natalie Price, S. el-Halabi, Naledi Mlaudzi, K. Keapoletswe, R. Lebelonyane, E. Fetogang, Tony Chebani, P. Kebaabetswe, T. Masupe, Keba Gabaake, A. Auld, O. Nkomazana, R. Marlink","doi":"10.1097/QAD.0000000000000921","DOIUrl":"https://doi.org/10.1097/QAD.0000000000000921","url":null,"abstract":"Objectives:To determine the incidence and risk factors of mortality for all HIV-infected patients receiving antiretroviral treatment at public and private healthcare facilities in the Botswana National HIV/AIDS Treatment Programme. Design:We studied routinely collected data from 226 030 patients enrolled in the Botswana National HIV/AIDS Treatment Programme from 2002 to 2013. Methods:A person-years (P-Y) approach was used to analyse all-cause mortality and follow-up rates for all HIV-infected individuals with documented antiretroviral therapy initiation dates. Marginal structural modelling was utilized to determine the effect of treatment on survival for those with documented drug regimens. Sensitivity analyses were performed to assess the robustness of our results. Results:Median follow-up time was 37 months (interquartile range 11–75). Mortality was highest during the first 3 months after treatment initiation at 11.79 (95% confidence interval 11.49–12.11) deaths per 100 P-Y, but dropped to 1.01 (95% confidence interval 0.98–1.04) deaths per 100 P-Y after the first year of treatment. Twelve-month mortality declined from 7 to 2% of initiates during 2002–2012. Tenofovir was associated with lower mortality than stavudine and zidovudine. Conclusion:The observed mortality rates have been declining over time; however, mortality in the first year, particularly first 3 months of antiretroviral treatment, remains a distinct problem. This analysis showed lower mortality with regimens containing tenofovir compared with zidovudine and stavudine. CD4+ cell count less than 100 cells/&mgr;l, older age and being male were associated with higher odds of mortality.","PeriodicalId":355297,"journal":{"name":"AIDS (London, England)","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130752799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 35

Once vs. twice-daily lopinavir/ritonavir in HIV-1-infected children hiv -1感染儿童洛匹那韦/利托那韦每日1次vs每日2次

AIDS (London, England) Pub Date : 2015-11-18 DOI: 10.1097/QAD.0000000000000862

{"title":"Once vs. twice-daily lopinavir/ritonavir in HIV-1-infected children","authors":"","doi":"10.1097/QAD.0000000000000862","DOIUrl":"https://doi.org/10.1097/QAD.0000000000000862","url":null,"abstract":"Objective:To evaluate whether once daily (q.d.) lopinavir/ritonavir is noninferior to twice daily (b.i.d.) dosing in children. Design:International, multicentre, phase II/III, randomized, open-label, noninferiority trial (KONCERT/PENTA18/ANRS150). Setting:Clinical centres participating in the PENTA, HIV-NAT and PHPT networks. Participants:Children/adolescents with HIV-1 RNA viral load less than 50 copies/ml for at least 24 weeks on lopinavir/ritonavir-containing antiretroviral therapy. Intervention:Children were randomized to continue lopinavir/ritonavir b.i.d. or change to q.d. Main outcome measure:Confirmed viral load ≥50 copies/ml by 48 weeks (12% noninferiority margin). Results:One hundred seventy-three children were randomized in the KONCERT trial (86 q.d., 87 b.i.d.); 46% men, median (IQR) age 11 (9–14) years, CD4% 33 (27–38)%. By week 48, 97 and 98% of time was spent on q.d. and b.i.d., respectively (one q.d. child lost at week 4). Twelve q.d. vs. seven b.i.d. children had confirmed viral load ≥50 copies/ml within 48 weeks; estimated difference in percentage with viral load rebound 6% [90% CI (–2, 14)]. Numbers of children with grade 3/4 adverse events (11 vs. 7) or major resistance mutations (3 vs. 2) were similar, q.d. vs. b.i.d. (both P > 0.3). Among 26 children in an intrasubject lopinavir/ritonavir pharmacokinetic substudy, lower daily exposure (AUC0–24 161 h.mg/l vs. 224 h.mg/l) and lower Clast (1.03 mg/l vs. 5.69 mg/l) were observed with q.d. vs. b.i.d. dosing. Conclusion:Noninferiority for viral load suppression on q.d. vs. b.i.d. lopinavir/ritonavir was not demonstrated. Although results, therefore, do not support routine use of q.d. lopinavir/ritonavir, lack of safety concerns or resistance suggest that q.d. dosing remains an option in selected, adherent children, with close viral load monitoring.","PeriodicalId":355297,"journal":{"name":"AIDS (London, England)","volume":"413 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129280218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 15

Field accuracy of fourth-generation rapid diagnostic tests for acute HIV-1: a systematic review 第四代急性HIV-1快速诊断试验的现场准确性:系统评价

AIDS (London, England) Pub Date : 2015-11-18 DOI: 10.1097/QAD.0000000000000855

J. Lewis, P. MacPherson, E. Adams, E. Ochodo, A. Sands, M. Taegtmeyer

引用次数: 33

CD4+ cell dynamics in untreated HIV-1 infection: overall rates, and effects of age, viral load, sex and calendar time 未经治疗的HIV-1感染中的CD4+细胞动力学:总体发病率，以及年龄、病毒载量、性别和日历时间的影响

AIDS (London, England) Pub Date : 2015-11-18 DOI: 10.1097/QAD.0000000000000854

{"title":"CD4+ cell dynamics in untreated HIV-1 infection: overall rates, and effects of age, viral load, sex and calendar time","authors":"","doi":"10.1097/QAD.0000000000000854","DOIUrl":"https://doi.org/10.1097/QAD.0000000000000854","url":null,"abstract":"Background:CD4+ cell count is a key measure of HIV disease progression, and the basis of successive international guidelines for treatment initiation. CD4+ cell dynamics are used in mathematical and econometric models for evaluating public health need and interventions. Here, we estimate rates of CD4+ decline, stratified by relevant covariates, in a form that is clinically transparent and can be directly used in such models. Methods:We analyse the AIDS Therapy Evaluation in the Netherlands cohort, including individuals with date of seroconversion estimated to be within 1 year and with intensive clinical follow-up prior to treatment initiation. Owing to the fact that CD4+ cell counts are intrinsically noisy, we separate the analysis into long-term trends of smoothed CD4+ cell counts and an observation model relating actual CD4+ measurements to the underlying smoothed counts. We use a monotonic spline smoothing model to describe the decline of smoothed CD4+ cell counts through categories CD4+ above 500, 350–500, 200–350 and 200 cells/&mgr;l or less. We estimate the proportion of individuals starting in each category after seroconversion and the average time spent in each category. We examine individual-level cofactors which influence these parameters. Results:Among untreated individuals, the time spent in each compartment was 3.32, 2.70, 5.50 and 5.06 years. Only 76% started in the CD4+ cell count above 500 cells/&mgr;l compartment after seroconversion. Set-point viral load (SPVL) was an important factor: individuals with at least 5 log10 copies/ml took 5.37 years to reach CD4+ cell count less than 200 cells/&mgr;l compared with 15.76 years for SPVL less than 4 log10 copies/ml. Conclusion:Many individuals already have CD4+ cell count below 500 cells/&mgr;l after seroconversion. SPVL strongly influences the rate of CD4+ decline. Treatment guidelines should consider measuring SPVL, whereas mathematical models should incorporate SPVL stratification.","PeriodicalId":355297,"journal":{"name":"AIDS (London, England)","volume":"66 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123819496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 40

The risk of viral rebound in the year after delivery in women remaining on antiretroviral therapy 继续接受抗逆转录病毒治疗的妇女分娩后一年内病毒反弹的风险

AIDS (London, England) Pub Date : 2015-11-01 DOI: 10.1097/QAD.0000000000000826

S. Huntington, C. Thorne, M. Newell, Jane Anderson, G. Taylor, D. Pillay, T. Hill, P. Tookey, C. Sabin

{"title":"The risk of viral rebound in the year after delivery in women remaining on antiretroviral therapy","authors":"S. Huntington, C. Thorne, M. Newell, Jane Anderson, G. Taylor, D. Pillay, T. Hill, P. Tookey, C. Sabin","doi":"10.1097/QAD.0000000000000826","DOIUrl":"https://doi.org/10.1097/QAD.0000000000000826","url":null,"abstract":"Objective:The objective of this study is to assess the risk of viral rebound in postpartum women on suppressive combination antiretroviral therapy (cART). Methods:Using data from the UK Collaborative HIV Cohort (UK CHIC) study and the UK and Ireland National Study of HIV in Pregnancy and Childhood (NSHPC), women with HIV-RNA 50 copies/ml or less at delivery in 2006–2011, who started life-long cART during pregnancy (n = 321) or conceived on cART (n = 618), were matched by age, duration on cART and time period, with at least one control (non-postpartum). The cumulative probability of viral rebound (HIV-RNA >200 copies/ml) was assessed by Kaplan–Meier analysis; adjusted hazard ratios (aHRs) for the 0–3 and 3–12 months postdelivery (cases)/pseudo-delivery (controls) were calculated in Cox proportional hazards models. Results:In postpartum women who conceived on cART, 5.9% [95% confidence interval (95% CI) 4.0–7.7] experienced viral rebound by 3 months, and 2.2% (1.4–3.0%) of their controls. The risk of viral rebound was higher in postpartum women than in controls during the first 3 months [aHR 2.63 (1.58–4.39)] but not during the 3–12 months postdelivery/pseudo-delivery. In postpartum women who started cART during pregnancy, 27% (22–32%) experienced viral rebound by 3 months, and 3.0% (1.6–4.4%) of their controls. The risk of viral rebound was higher in postpartum women than in controls during both postdelivery/pseudo-delivery periods [<3 months: aHR 6.63 (3.58–12.29); 3–12 months: aHR 4.05 (2.03–8.09)]. Conclusion:In women on suppressive cART, the risk of viral rebound is increased following delivery, especially in the first 3 months, which may be related to reduced adherence, indicating the need for additional adherence support for postpartum women.","PeriodicalId":355297,"journal":{"name":"AIDS (London, England)","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116692437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 29

Does rapid HIV disease progression prior to combination antiretroviral therapy hinder optimal CD4+ T-cell recovery once HIV-1 suppression is achieved? 联合抗逆转录病毒治疗前HIV疾病的快速进展是否会阻碍HIV-1抑制后CD4+ t细胞的最佳恢复?

AIDS (London, England) Pub Date : 2015-10-28 DOI: 10.1097/QAD.0000000000000805

I. Jarrín, N. Pantazis, J. Dalmau, A. Phillips, A. Olson, C. Mussini, F. Boufassa, D. Costagliola, K. Porter, J. Blanco, J. Del Amo, J. Martinez-Picado

{"title":"Does rapid HIV disease progression prior to combination antiretroviral therapy hinder optimal CD4+ T-cell recovery once HIV-1 suppression is achieved?","authors":"I. Jarrín, N. Pantazis, J. Dalmau, A. Phillips, A. Olson, C. Mussini, F. Boufassa, D. Costagliola, K. Porter, J. Blanco, J. Del Amo, J. Martinez-Picado","doi":"10.1097/QAD.0000000000000805","DOIUrl":"https://doi.org/10.1097/QAD.0000000000000805","url":null,"abstract":"Objective:This article compares trends in CD4+ T-cell recovery and proportions achieving optimal restoration (≥500 cells/&mgr;l) after viral suppression following combination antiretroviral therapy (cART) initiation between rapid and nonrapid progressors. Methods:We included HIV-1 seroconverters achieving viral suppression within 6 months of cART. Rapid progressors were individuals experiencing at least one CD4+ less than 200 cells/&mgr;l within 12 months of seroconverters before cART. We used piecewise linear mixed models and logistic regression for optimal restoration. Results:Of 4024 individuals, 294 (7.3%) were classified as rapid progressors. At the same CD4+ T-cell count at cART start (baseline), rapid progressors experienced faster CD4+ T-cell increases than nonrapid progressors in first month [difference (95% confidence interval) in mean increase/month (square root scale): 1.82 (1.61; 2.04)], which reversed to slightly slower increases in months 1–18 [−0.05 (−0.06; −0.03)] and no significant differences in 18–60 months [−0.003 (−0.01; 0.01)]. Percentage achieving optimal restoration was significantly lower for rapid progressors than nonrapid progressors at months 12 (29.2 vs. 62.5%) and 36 (47.1 vs. 72.4%) but not at month 60 (70.4 vs. 71.8%). These differences disappeared after adjusting for baseline CD4+ T-cell count: odds ratio (95% confidence interval) 0.86 (0.61; 1.20), 0.90 (0.38; 2.17) and 1.56 (0.55; 4.46) at months 12, 36 and 60, respectively. Conclusion:Among people on suppressive antiretroviral therapy, rapid progressors experience faster initial increases of CD4+ T-cell counts than nonrapid progressors, but are less likely to achieve optimal restoration during the first 36 months after cART, mainly because of lower CD4+ T-cell counts at cART initiation.","PeriodicalId":355297,"journal":{"name":"AIDS (London, England)","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131614221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 21