Abstract
| Original language | English |
|---|---|
| Pages (from-to) | 2377-2385 |
| Number of pages | 9 |
| Journal | AIDS |
| Volume | 31 |
| Issue number | 17 |
| DOIs | |
| Publication status | Published - 13 Nov 2017 |
Keywords
- antiretroviral therapy
- cascade
- HIV diagnosis
- HIV treatment
- treatment as prevention
Cite this
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Time from HIV infection to virological suppression: dramatic fall from 2007 to 2016. / Medland, Nicholas A.; Nicholson, Suellen; Chow, Eric P.F.; Read, Timothy R.H.; Bradshaw, Catriona S.; Denham, Ian; Fairley, Christopher K.
In: AIDS, Vol. 31, No. 17, 13.11.2017, p. 2377-2385.Research output: Contribution to journal › Review Article › Research › peer-review
TY - JOUR
T1 - Time from HIV infection to virological suppression: dramatic fall from 2007 to 2016
AU - Medland, Nicholas A.
AU - Nicholson, Suellen
AU - Chow, Eric P.F.
AU - Read, Timothy R.H.
AU - Bradshaw, Catriona S.
AU - Denham, Ian
AU - Fairley, Christopher K.
PY - 2017/11/13
Y1 - 2017/11/13
N2 - AIM: Time from HIV infection to virological suppression: dramatic fall from 2007 to 2016. OBJECTIVES: We examined the time from HIV infection to virological suppression in MSM who were first diagnosed at Melbourne Sexual Health Centre between 2007 and 2016. DESIGN: Retrospective cohort. METHODS: Date of infection was imputed from the testing history or serological evidence of recent infection (negative or indeterminate western blot) or baseline CD4 cell count. Date of virological suppression was determined using clinical viral load data. We analysed predictors of diagnosis with serological evidence of recent infection (logistic regression) and time from diagnosis to suppression and from infection to suppression (Cox regression) using demographic, clinical, and behavioral covariates. RESULTS: Between 2007 and 2016, the median time from HIV infection to diagnosis fell from 6.8 to 4.3 months (P = 0.001), from diagnosis to suppression fell from 22.7 to 3.2 months (P < 0.0001), and from infection to suppression fell from 49.0 to 9.6 months (P < 0.0001). Serological evidence of recent infection increased from 15.6 to 34.3% (P < 0.0001) of diagnoses. In the multivariate analyses, age, being recently arrived from a non-English speaking country, history of IDU, other sexually transmitted infections, and sexual risk were not associated with any of these measures. CONCLUSION: The duration of infectiousness in MSM diagnosed with HIV infection at Melbourne Sexual Health Centre in Victoria has fallen dramatically between 2007 and 2016 and the proportion diagnosed with serological evidence of recent infection has increased. This effect is observed across all population subgroups and marks a positive milestone for the treatment as prevention paradigm.
AB - AIM: Time from HIV infection to virological suppression: dramatic fall from 2007 to 2016. OBJECTIVES: We examined the time from HIV infection to virological suppression in MSM who were first diagnosed at Melbourne Sexual Health Centre between 2007 and 2016. DESIGN: Retrospective cohort. METHODS: Date of infection was imputed from the testing history or serological evidence of recent infection (negative or indeterminate western blot) or baseline CD4 cell count. Date of virological suppression was determined using clinical viral load data. We analysed predictors of diagnosis with serological evidence of recent infection (logistic regression) and time from diagnosis to suppression and from infection to suppression (Cox regression) using demographic, clinical, and behavioral covariates. RESULTS: Between 2007 and 2016, the median time from HIV infection to diagnosis fell from 6.8 to 4.3 months (P = 0.001), from diagnosis to suppression fell from 22.7 to 3.2 months (P < 0.0001), and from infection to suppression fell from 49.0 to 9.6 months (P < 0.0001). Serological evidence of recent infection increased from 15.6 to 34.3% (P < 0.0001) of diagnoses. In the multivariate analyses, age, being recently arrived from a non-English speaking country, history of IDU, other sexually transmitted infections, and sexual risk were not associated with any of these measures. CONCLUSION: The duration of infectiousness in MSM diagnosed with HIV infection at Melbourne Sexual Health Centre in Victoria has fallen dramatically between 2007 and 2016 and the proportion diagnosed with serological evidence of recent infection has increased. This effect is observed across all population subgroups and marks a positive milestone for the treatment as prevention paradigm.
KW - antiretroviral therapy
KW - cascade
KW - HIV diagnosis
KW - HIV treatment
KW - treatment as prevention
UR - http://www.scopus.com/inward/record.url?scp=85034076382&partnerID=8YFLogxK
U2 - 10.1097/QAD.0000000000001634
DO - 10.1097/QAD.0000000000001634
M3 - Review Article
VL - 31
SP - 2377
EP - 2385
JO - AIDS
JF - AIDS
SN - 0269-9370
IS - 17
ER -