Time from HIV infection to virological suppression: dramatic fall from 2007 to 2016

Nicholas A. Medland, Suellen Nicholson, Eric P.F. Chow, Timothy R.H. Read, Catriona S. Bradshaw, Ian Denham, Christopher K. Fairley

Research output: Contribution to journalReview ArticleResearchpeer-review

Abstract

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.
Original languageEnglish
Pages (from-to)2377-2385
Number of pages9
JournalAIDS
Volume31
Issue number17
DOIs
Publication statusPublished - 13 Nov 2017

Keywords

  • antiretroviral therapy
  • cascade
  • HIV diagnosis
  • HIV treatment
  • treatment as prevention

Cite this

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title = "Time from HIV infection to virological suppression: dramatic fall from 2007 to 2016",
abstract = "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.",
keywords = "antiretroviral therapy, cascade, HIV diagnosis, HIV treatment, treatment as prevention",
author = "Medland, {Nicholas A.} and Suellen Nicholson and Chow, {Eric P.F.} and Read, {Timothy R.H.} and Bradshaw, {Catriona S.} and Ian Denham and Fairley, {Christopher K.}",
year = "2017",
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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 journalReview ArticleResearchpeer-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

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DO - 10.1097/QAD.0000000000001634

M3 - Review Article

VL - 31

SP - 2377

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SN - 0269-9370

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