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Level of adherence and HIV RNA suppression in the current era of highly active antiretroviral therapy (HAART).

ABSTRACT: The need to achieve ?95 % adherence to HAART for treatment effectiveness may be a barrier for universal initiation at early stages of HIV. Using longitudinal data collected from 2006 to 2011 from cohort studies of MSM (MACS) and IDUs (ALIVE study), we estimated the minimum adherence needed to achieve HIV RNA suppression (<50 copies/mL), defined as the level at which at least 80 % were virally suppressed, and the odds of suppression was not significantly different than that observed with ?95 % adherence. In the MACS, ?80 % suppression was observed with 80-84 % adherence and the odds ratio for suppression (vs. ?95 % adherence) was 1.43 (0.61, 3.33). In the ALIVE study where <35 % were on newer drugs, only 71.4 % were suppressed among those who reported ?95 % adherence. Although IDUs on older HAART regimens may need to be ?95 % adherent, concerns related to non-adherence may be less of a barrier to initiation of modern HAART regimens.

SUBMITTER: Viswanathan S

PROVIDER: S-EPMC4393774 | biostudies-literature | 2015 Apr

REPOSITORIES: biostudies-literature

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Level of adherence and HIV RNA suppression in the current era of highly active antiretroviral therapy (HAART).

Viswanathan Shilpa S Detels Roger R Mehta Shruti H SH Macatangay Bernard J C BJ Kirk Gregory D GD Jacobson Lisa P LP

AIDS and behavior 20150401 4

The need to achieve ≥95 % adherence to HAART for treatment effectiveness may be a barrier for universal initiation at early stages of HIV. Using longitudinal data collected from 2006 to 2011 from cohort studies of MSM (MACS) and IDUs (ALIVE study), we estimated the minimum adherence needed to achieve HIV RNA suppression (<50 copies/mL), defined as the level at which at least 80 % were virally suppressed, and the odds of suppression was not significantly different than that observed with ≥95 % ad ...[more]

PMID: 25342151

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Project description:BackgroundCandidiasis is the most common opportunistic infection seen in human immunodeficiency virus (HIV)-infected individuals. The aim of our study was to estimate the candidiasis rate and evaluate its trend in HIV-infected children in Spain during the era of highly active antiretroviral therapy (HAART) compared to HIV-uninfected children.MethodsWe carried out a retrospective study. Data were obtained from the records of the Minimum Basic Data Set from hospitals in Spain. All HIV-infected children were under 17 years of age, and a group of HIV-uninfected children with hospital admissions matching the study group by gender and age were randomly selected. The follow-up period (1997-2008) was divided into three calendar periods: a) From 1997 to 1999 for early-period HAART; b) from 2000 to 2002 for mid-period HAART; and c) from 2003 to 2008 for late-period HAART.ResultsAmong children with hospital admissions, HIV-infected children had much higher values than HIV-uninfected children during each of the three calendar periods for overall candidiasis rates (150.0 versus 6.1 events per 1,000 child hospital admissions/year (p?<?0.001), 90.3 versus 3.1 (p?<?0.001), and 79.3 versus 10.7 (p?<?0.001), respectively) and for non-invasive Candida mycosis (ICM) rates (118.5 versus 3.8 (p?<?0.001), 85.3 versus 2.3 (p?<?0.001), and 80.6 versus 6.0 (p?<?0.001), respectively). In addition, HIV-infected children also had higher values of ICM rates than HIV-uninfected children, except during the last calendar period when no significant difference was found (32.4 versus 1.2 (p?<?0.001), 11.6 versus 0.4 (p?<?0.001), and 4.6 versus 2.3 (p?=?0.387), respectively). For all children living with HIV/AIDS, the overall candidiasis rate (events per 1,000 HIV-infected children/year) decreased from 1997-1999 to 2000-2002 (18.8 to 10.6; p?<?0.001) and from 2000-2002 to 2003-2008 (10.6 to 5.7; p?=?0.060). Within each category of candidiasis, both non-ICM and ICM rates experienced significant decreases from 1997-1999 to 2003-2008 (15.9 to 5.7 (p?<?0.001) and 4.1 to 0.3 (p?<?0.001), respectively).ConclusionsAlthough the candidiasis rate still remains higher than in the general population (from 1997 to 2008), candidiasis diagnoses have decreased among HIV-infected children throughout the HAART era, and it has ceased to be a major health problem among children with HIV infection.

Dataset Information

Level of adherence and HIV RNA suppression in the current era of highly active antiretroviral therapy (HAART).

Publications

Level of adherence and HIV RNA suppression in the current era of highly active antiretroviral therapy (HAART).

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