Heterogeneity in outcomes of treated HIV-positive patients in Europe and North America: relation with patient and cohort characteristics
Identifieur interne : 001685 ( Pmc/Corpus ); précédent : 001684; suivant : 001686Heterogeneity in outcomes of treated HIV-positive patients in Europe and North America: relation with patient and cohort characteristics
Auteurs : Margaret T. May ; Robert S. Hogg ; Amy C. Justice ; Bryan E. Shepherd ; Dominique Costagliola ; Bruno Ledergerber ; Rodolphe Thiébaut ; M John Gill ; Ole Kirk ; Ard Van Sighem ; Michael S. Saag ; Gemma Navarro ; Paz Sobrino-Vegas ; Fiona Lampe ; Suzanne Ingle ; Jodie L. Guest ; Heidi M. Crane ; Antonella D Rminio Monforte ; Jörg J. Vehreschild ; Jonathan Ac SterneSource :
- International Journal of Epidemiology [ 0300-5771 ] ; 2012.
Abstract
Url:
DOI: 10.1093/ije/dys164
PubMed: 23148105
PubMed Central: 3535877
Links to Exploration step
PMC:3535877Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Heterogeneity in outcomes of treated HIV-positive patients in Europe and
North America: relation with patient and cohort characteristics</title><author><name sortKey="May, Margaret T" sort="May, Margaret T" uniqKey="May M" first="Margaret T" last="May">Margaret T. May</name><affiliation><nlm:aff id="dys164-AFF1">School of Social and Community Medicine, University of Bristol, Bristol, UK,</nlm:aff></affiliation></author><author><name sortKey="Hogg, Robert S" sort="Hogg, Robert S" uniqKey="Hogg R" first="Robert S" last="Hogg">Robert S. Hogg</name><affiliation><nlm:aff id="dys164-AFF1">Division of Epidemiology and Population Health, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada,</nlm:aff></affiliation><affiliation><nlm:aff id="dys164-AFF1">Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada,</nlm:aff></affiliation></author><author><name sortKey="Justice, Amy C" sort="Justice, Amy C" uniqKey="Justice A" first="Amy C" last="Justice">Amy C. Justice</name><affiliation><nlm:aff id="dys164-AFF1">Center for Interdisciplinary Research on AIDS, Yale University School of Medicine, New Haven, CT, USA,</nlm:aff></affiliation><affiliation><nlm:aff id="dys164-AFF1">VA Connecticut Healthcare System, West Haven, CT, USA,</nlm:aff></affiliation></author><author><name sortKey="Shepherd, Bryan E" sort="Shepherd, Bryan E" uniqKey="Shepherd B" first="Bryan E" last="Shepherd">Bryan E. Shepherd</name><affiliation><nlm:aff id="dys164-AFF1">Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, TN, USA,</nlm:aff></affiliation></author><author><name sortKey="Costagliola, Dominique" sort="Costagliola, Dominique" uniqKey="Costagliola D" first="Dominique" last="Costagliola">Dominique Costagliola</name><affiliation><nlm:aff id="dys164-AFF1">INSERM, U943, F-75013 Paris, France,</nlm:aff></affiliation><affiliation><nlm:aff id="dys164-AFF1">UPMC University Paris 06, UMR S943, F-75013 Paris, France,</nlm:aff></affiliation><affiliation><nlm:aff id="dys164-AFF1">AP-HP, Groupe hospitalier Pitié-Salpêtrière, Service de Maladies Infectieuses et Tropicales, F-75013 Paris, France,</nlm:aff></affiliation></author><author><name sortKey="Ledergerber, Bruno" sort="Ledergerber, Bruno" uniqKey="Ledergerber B" first="Bruno" last="Ledergerber">Bruno Ledergerber</name><affiliation><nlm:aff id="dys164-AFF1">Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Switzerland,</nlm:aff></affiliation></author><author><name sortKey="Thiebaut, Rodolphe" sort="Thiebaut, Rodolphe" uniqKey="Thiebaut R" first="Rodolphe" last="Thiébaut">Rodolphe Thiébaut</name><affiliation><nlm:aff id="dys164-AFF1">University Bordeaux, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, F-33000 Bordeaux, France,</nlm:aff></affiliation><affiliation><nlm:aff id="dys164-AFF1">INSERM, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, F-33000 Bordeaux, France,</nlm:aff></affiliation></author><author><name sortKey="Gill, M John" sort="Gill, M John" uniqKey="Gill M" first="M John" last="Gill">M John Gill</name><affiliation><nlm:aff id="dys164-AFF1">Division of Infectious Diseases, University of Calgary, Calgary, Canada,</nlm:aff></affiliation></author><author><name sortKey="Kirk, Ole" sort="Kirk, Ole" uniqKey="Kirk O" first="Ole" last="Kirk">Ole Kirk</name><affiliation><nlm:aff id="dys164-AFF1">Copenhagen HIV Programme, Panum Institute, University of Copenhagen, Denmark,</nlm:aff></affiliation><affiliation><nlm:aff id="dys164-AFF1">Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark,</nlm:aff></affiliation></author><author><name sortKey="Van Sighem, Ard" sort="Van Sighem, Ard" uniqKey="Van Sighem A" first="Ard" last="Van Sighem">Ard Van Sighem</name><affiliation><nlm:aff id="dys164-AFF1">Stichting HIV Monitoring, Amsterdam, The Netherlands,</nlm:aff></affiliation></author><author><name sortKey="Saag, Michael S" sort="Saag, Michael S" uniqKey="Saag M" first="Michael S" last="Saag">Michael S. Saag</name><affiliation><nlm:aff id="dys164-AFF1">Division of Infectious Disease, Department of Medicine, University of Alabama, Birmingham, AL, USA,</nlm:aff></affiliation></author><author><name sortKey="Navarro, Gemma" sort="Navarro, Gemma" uniqKey="Navarro G" first="Gemma" last="Navarro">Gemma Navarro</name><affiliation><nlm:aff id="dys164-AFF1">Infectious Diseases Program, Corporació Sanitària Parc Taulí, Sabadell, Barcelona, Spain,</nlm:aff></affiliation></author><author><name sortKey="Sobrino Vegas, Paz" sort="Sobrino Vegas, Paz" uniqKey="Sobrino Vegas P" first="Paz" last="Sobrino-Vegas">Paz Sobrino-Vegas</name><affiliation><nlm:aff id="dys164-AFF1">Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain,</nlm:aff></affiliation></author><author><name sortKey="Lampe, Fiona" sort="Lampe, Fiona" uniqKey="Lampe F" first="Fiona" last="Lampe">Fiona Lampe</name><affiliation><nlm:aff id="dys164-AFF1">Research Department of Infection and Population Health, UCL Medical School, London, UK,</nlm:aff></affiliation></author><author><name sortKey="Ingle, Suzanne" sort="Ingle, Suzanne" uniqKey="Ingle S" first="Suzanne" last="Ingle">Suzanne Ingle</name><affiliation><nlm:aff id="dys164-AFF1">School of Social and Community Medicine, University of Bristol, Bristol, UK,</nlm:aff></affiliation></author><author><name sortKey="Guest, Jodie L" sort="Guest, Jodie L" uniqKey="Guest J" first="Jodie L" last="Guest">Jodie L. Guest</name><affiliation><nlm:aff id="dys164-AFF1">HIV Atlanta VA Cohort Study (HAVACS), Atlanta Veterans Affairs Medical Center, Decatur, GA, USA,</nlm:aff></affiliation></author><author><name sortKey="Crane, Heidi M" sort="Crane, Heidi M" uniqKey="Crane H" first="Heidi M" last="Crane">Heidi M. Crane</name><affiliation><nlm:aff id="dys164-AFF1">University of Washington School of Medicine, Seattle, WA, USA,</nlm:aff></affiliation></author><author><name sortKey="D Rminio Monforte, Antonella" sort="D Rminio Monforte, Antonella" uniqKey="D Rminio Monforte A" first="Antonella" last="D Rminio Monforte">Antonella D Rminio Monforte</name><affiliation><nlm:aff wicri:cut=" and" id="dys164-AFF1">Clinic of Infectious Diseases and Tropical Medicine, San Paolo Hospital, University of Milan, Italy</nlm:aff></affiliation></author><author><name sortKey="Vehreschild, Jorg J" sort="Vehreschild, Jorg J" uniqKey="Vehreschild J" first="Jörg J" last="Vehreschild">Jörg J. Vehreschild</name><affiliation><nlm:aff id="dys164-AFF1">First Department of Internal Medicine, University Hospital of Cologne, Cologne, Germany</nlm:aff></affiliation></author><author><name sortKey="Sterne, Jonathan Ac" sort="Sterne, Jonathan Ac" uniqKey="Sterne J" first="Jonathan Ac" last="Sterne">Jonathan Ac Sterne</name><affiliation><nlm:aff id="dys164-AFF1">School of Social and Community Medicine, University of Bristol, Bristol, UK,</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">23148105</idno><idno type="pmc">3535877</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3535877</idno><idno type="RBID">PMC:3535877</idno><idno type="doi">10.1093/ije/dys164</idno><date when="2012">2012</date><idno type="wicri:Area/Pmc/Corpus">001685</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001685</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Heterogeneity in outcomes of treated HIV-positive patients in Europe and
North America: relation with patient and cohort characteristics</title><author><name sortKey="May, Margaret T" sort="May, Margaret T" uniqKey="May M" first="Margaret T" last="May">Margaret T. May</name><affiliation><nlm:aff id="dys164-AFF1">School of Social and Community Medicine, University of Bristol, Bristol, UK,</nlm:aff></affiliation></author><author><name sortKey="Hogg, Robert S" sort="Hogg, Robert S" uniqKey="Hogg R" first="Robert S" last="Hogg">Robert S. Hogg</name><affiliation><nlm:aff id="dys164-AFF1">Division of Epidemiology and Population Health, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada,</nlm:aff></affiliation><affiliation><nlm:aff id="dys164-AFF1">Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada,</nlm:aff></affiliation></author><author><name sortKey="Justice, Amy C" sort="Justice, Amy C" uniqKey="Justice A" first="Amy C" last="Justice">Amy C. Justice</name><affiliation><nlm:aff id="dys164-AFF1">Center for Interdisciplinary Research on AIDS, Yale University School of Medicine, New Haven, CT, USA,</nlm:aff></affiliation><affiliation><nlm:aff id="dys164-AFF1">VA Connecticut Healthcare System, West Haven, CT, USA,</nlm:aff></affiliation></author><author><name sortKey="Shepherd, Bryan E" sort="Shepherd, Bryan E" uniqKey="Shepherd B" first="Bryan E" last="Shepherd">Bryan E. Shepherd</name><affiliation><nlm:aff id="dys164-AFF1">Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, TN, USA,</nlm:aff></affiliation></author><author><name sortKey="Costagliola, Dominique" sort="Costagliola, Dominique" uniqKey="Costagliola D" first="Dominique" last="Costagliola">Dominique Costagliola</name><affiliation><nlm:aff id="dys164-AFF1">INSERM, U943, F-75013 Paris, France,</nlm:aff></affiliation><affiliation><nlm:aff id="dys164-AFF1">UPMC University Paris 06, UMR S943, F-75013 Paris, France,</nlm:aff></affiliation><affiliation><nlm:aff id="dys164-AFF1">AP-HP, Groupe hospitalier Pitié-Salpêtrière, Service de Maladies Infectieuses et Tropicales, F-75013 Paris, France,</nlm:aff></affiliation></author><author><name sortKey="Ledergerber, Bruno" sort="Ledergerber, Bruno" uniqKey="Ledergerber B" first="Bruno" last="Ledergerber">Bruno Ledergerber</name><affiliation><nlm:aff id="dys164-AFF1">Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Switzerland,</nlm:aff></affiliation></author><author><name sortKey="Thiebaut, Rodolphe" sort="Thiebaut, Rodolphe" uniqKey="Thiebaut R" first="Rodolphe" last="Thiébaut">Rodolphe Thiébaut</name><affiliation><nlm:aff id="dys164-AFF1">University Bordeaux, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, F-33000 Bordeaux, France,</nlm:aff></affiliation><affiliation><nlm:aff id="dys164-AFF1">INSERM, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, F-33000 Bordeaux, France,</nlm:aff></affiliation></author><author><name sortKey="Gill, M John" sort="Gill, M John" uniqKey="Gill M" first="M John" last="Gill">M John Gill</name><affiliation><nlm:aff id="dys164-AFF1">Division of Infectious Diseases, University of Calgary, Calgary, Canada,</nlm:aff></affiliation></author><author><name sortKey="Kirk, Ole" sort="Kirk, Ole" uniqKey="Kirk O" first="Ole" last="Kirk">Ole Kirk</name><affiliation><nlm:aff id="dys164-AFF1">Copenhagen HIV Programme, Panum Institute, University of Copenhagen, Denmark,</nlm:aff></affiliation><affiliation><nlm:aff id="dys164-AFF1">Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark,</nlm:aff></affiliation></author><author><name sortKey="Van Sighem, Ard" sort="Van Sighem, Ard" uniqKey="Van Sighem A" first="Ard" last="Van Sighem">Ard Van Sighem</name><affiliation><nlm:aff id="dys164-AFF1">Stichting HIV Monitoring, Amsterdam, The Netherlands,</nlm:aff></affiliation></author><author><name sortKey="Saag, Michael S" sort="Saag, Michael S" uniqKey="Saag M" first="Michael S" last="Saag">Michael S. Saag</name><affiliation><nlm:aff id="dys164-AFF1">Division of Infectious Disease, Department of Medicine, University of Alabama, Birmingham, AL, USA,</nlm:aff></affiliation></author><author><name sortKey="Navarro, Gemma" sort="Navarro, Gemma" uniqKey="Navarro G" first="Gemma" last="Navarro">Gemma Navarro</name><affiliation><nlm:aff id="dys164-AFF1">Infectious Diseases Program, Corporació Sanitària Parc Taulí, Sabadell, Barcelona, Spain,</nlm:aff></affiliation></author><author><name sortKey="Sobrino Vegas, Paz" sort="Sobrino Vegas, Paz" uniqKey="Sobrino Vegas P" first="Paz" last="Sobrino-Vegas">Paz Sobrino-Vegas</name><affiliation><nlm:aff id="dys164-AFF1">Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain,</nlm:aff></affiliation></author><author><name sortKey="Lampe, Fiona" sort="Lampe, Fiona" uniqKey="Lampe F" first="Fiona" last="Lampe">Fiona Lampe</name><affiliation><nlm:aff id="dys164-AFF1">Research Department of Infection and Population Health, UCL Medical School, London, UK,</nlm:aff></affiliation></author><author><name sortKey="Ingle, Suzanne" sort="Ingle, Suzanne" uniqKey="Ingle S" first="Suzanne" last="Ingle">Suzanne Ingle</name><affiliation><nlm:aff id="dys164-AFF1">School of Social and Community Medicine, University of Bristol, Bristol, UK,</nlm:aff></affiliation></author><author><name sortKey="Guest, Jodie L" sort="Guest, Jodie L" uniqKey="Guest J" first="Jodie L" last="Guest">Jodie L. Guest</name><affiliation><nlm:aff id="dys164-AFF1">HIV Atlanta VA Cohort Study (HAVACS), Atlanta Veterans Affairs Medical Center, Decatur, GA, USA,</nlm:aff></affiliation></author><author><name sortKey="Crane, Heidi M" sort="Crane, Heidi M" uniqKey="Crane H" first="Heidi M" last="Crane">Heidi M. Crane</name><affiliation><nlm:aff id="dys164-AFF1">University of Washington School of Medicine, Seattle, WA, USA,</nlm:aff></affiliation></author><author><name sortKey="D Rminio Monforte, Antonella" sort="D Rminio Monforte, Antonella" uniqKey="D Rminio Monforte A" first="Antonella" last="D Rminio Monforte">Antonella D Rminio Monforte</name><affiliation><nlm:aff wicri:cut=" and" id="dys164-AFF1">Clinic of Infectious Diseases and Tropical Medicine, San Paolo Hospital, University of Milan, Italy</nlm:aff></affiliation></author><author><name sortKey="Vehreschild, Jorg J" sort="Vehreschild, Jorg J" uniqKey="Vehreschild J" first="Jörg J" last="Vehreschild">Jörg J. Vehreschild</name><affiliation><nlm:aff id="dys164-AFF1">First Department of Internal Medicine, University Hospital of Cologne, Cologne, Germany</nlm:aff></affiliation></author><author><name sortKey="Sterne, Jonathan Ac" sort="Sterne, Jonathan Ac" uniqKey="Sterne J" first="Jonathan Ac" last="Sterne">Jonathan Ac Sterne</name><affiliation><nlm:aff id="dys164-AFF1">School of Social and Community Medicine, University of Bristol, Bristol, UK,</nlm:aff></affiliation></author></analytic><series><title level="j">International Journal of Epidemiology</title><idno type="ISSN">0300-5771</idno><idno type="eISSN">1464-3685</idno><imprint><date when="2012">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><bold>Background</bold> HIV cohort collaborations, which pool data from diverse patient
cohorts, have provided key insights into outcomes of antiretroviral therapy (ART).
However, the extent of, and reasons for, between-cohort heterogeneity in rates of AIDS and
mortality are unclear.</p><p><bold>Methods</bold> We obtained data on adult HIV-positive patients who started ART from
1998 without a previous AIDS diagnosis from 17 cohorts in North America and Europe.
Patients were followed up from 1 month to 2 years after starting ART. We examined
between-cohort heterogeneity in crude and adjusted (age, sex, HIV transmission risk, year,
CD4 count and HIV-1 RNA at start of ART) rates of AIDS and mortality using random-effects
meta-analysis and meta-regression.</p><p><bold>Results</bold> During 61 520 person-years, 754/38 706 (1.9%) patients died
and 1890 (4.9%) progressed to AIDS. Between-cohort variance in mortality rates was
reduced from 0.84 to 0.24 (0.73 to 0.28 for AIDS rates) after adjustment for patient
characteristics. Adjusted mortality rates were inversely associated with cohorts’
estimated completeness of death ascertainment [excellent: 96–100%, good:
90–95%, average: 75–89%; mortality rate ratio 0.66 (95%
confidence interval 0.46–0.94) per category]. Mortality rate ratios comparing Europe
with North America were 0.42 (0.31–0.57) before and 0.47 (0.30–0.73) after
adjusting for completeness of ascertainment.</p><p><bold>Conclusions</bold> Heterogeneity between settings in outcomes of HIV treatment has
implications for collaborative analyses, policy and clinical care. Estimated mortality
rates may require adjustment for completeness of ascertainment. Higher mortality rate in
North American, compared with European, cohorts was not fully explained by completeness of
ascertainment and may be because of the inclusion of more socially marginalized patients
with higher mortality risk.</p></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Int J Epidemiol</journal-id><journal-id journal-id-type="iso-abbrev">Int J Epidemiol</journal-id><journal-id journal-id-type="publisher-id">ije</journal-id><journal-id journal-id-type="hwp">intjepid</journal-id><journal-title-group><journal-title>International Journal of Epidemiology</journal-title></journal-title-group><issn pub-type="ppub">0300-5771</issn><issn pub-type="epub">1464-3685</issn><publisher><publisher-name>Oxford University Press</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">23148105</article-id><article-id pub-id-type="pmc">3535877</article-id><article-id pub-id-type="doi">10.1093/ije/dys164</article-id><article-id pub-id-type="publisher-id">dys164</article-id><article-categories><subj-group subj-group-type="heading"><subject>Other Original Articles</subject></subj-group></article-categories><title-group><article-title>Heterogeneity in outcomes of treated HIV-positive patients in Europe and
North America: relation with patient and cohort characteristics</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>May</surname><given-names>Margaret T</given-names></name><xref ref-type="aff" rid="dys164-AFF1"><sup>1</sup></xref><xref ref-type="corresp" rid="dys164-COR1">*</xref></contrib><contrib contrib-type="author"><name><surname>Hogg</surname><given-names>Robert S</given-names></name><xref ref-type="aff" rid="dys164-AFF1"><sup>2</sup></xref><xref ref-type="aff" rid="dys164-AFF1"><sup>3</sup></xref></contrib><contrib contrib-type="author"><name><surname>Justice</surname><given-names>Amy C</given-names></name><xref ref-type="aff" rid="dys164-AFF1"><sup>4</sup></xref><xref ref-type="aff" rid="dys164-AFF1"><sup>5</sup></xref></contrib><contrib contrib-type="author"><name><surname>Shepherd</surname><given-names>Bryan E</given-names></name><xref ref-type="aff" rid="dys164-AFF1"><sup>6</sup></xref></contrib><contrib contrib-type="author"><name><surname>Costagliola</surname><given-names>Dominique</given-names></name><xref ref-type="aff" rid="dys164-AFF1"><sup>7</sup></xref><xref ref-type="aff" rid="dys164-AFF1"><sup>8</sup></xref><xref ref-type="aff" rid="dys164-AFF1"><sup>9</sup></xref></contrib><contrib contrib-type="author"><name><surname>Ledergerber</surname><given-names>Bruno</given-names></name><xref ref-type="aff" rid="dys164-AFF1"><sup>10</sup></xref></contrib><contrib contrib-type="author"><name><surname>Thiébaut</surname><given-names>Rodolphe</given-names></name><xref ref-type="aff" rid="dys164-AFF1"><sup>11</sup></xref><xref ref-type="aff" rid="dys164-AFF1"><sup>12</sup></xref></contrib><contrib contrib-type="author"><name><surname>Gill</surname><given-names>M John</given-names></name><xref ref-type="aff" rid="dys164-AFF1"><sup>13</sup></xref></contrib><contrib contrib-type="author"><name><surname>Kirk</surname><given-names>Ole</given-names></name><xref ref-type="aff" rid="dys164-AFF1"><sup>14</sup></xref><xref ref-type="aff" rid="dys164-AFF1"><sup>15</sup></xref></contrib><contrib contrib-type="author"><name><surname>van Sighem</surname><given-names>Ard</given-names></name><xref ref-type="aff" rid="dys164-AFF1"><sup>16</sup></xref></contrib><contrib contrib-type="author"><name><surname>Saag</surname><given-names>Michael S</given-names></name><xref ref-type="aff" rid="dys164-AFF1"><sup>17</sup></xref></contrib><contrib contrib-type="author"><name><surname>Navarro</surname><given-names>Gemma</given-names></name><xref ref-type="aff" rid="dys164-AFF1"><sup>18</sup></xref></contrib><contrib contrib-type="author"><name><surname>Sobrino-Vegas</surname><given-names>Paz</given-names></name><xref ref-type="aff" rid="dys164-AFF1"><sup>19</sup></xref></contrib><contrib contrib-type="author"><name><surname>Lampe</surname><given-names>Fiona</given-names></name><xref ref-type="aff" rid="dys164-AFF1"><sup>20</sup></xref></contrib><contrib contrib-type="author"><name><surname>Ingle</surname><given-names>Suzanne</given-names></name><xref ref-type="aff" rid="dys164-AFF1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Guest</surname><given-names>Jodie L</given-names></name><xref ref-type="aff" rid="dys164-AFF1"><sup>21</sup></xref></contrib><contrib contrib-type="author"><name><surname>Crane</surname><given-names>Heidi M</given-names></name><xref ref-type="aff" rid="dys164-AFF1"><sup>22</sup></xref></contrib><contrib contrib-type="author"><name><surname>D’Arminio Monforte</surname><given-names>Antonella</given-names></name><xref ref-type="aff" rid="dys164-AFF1"><sup>23</sup></xref></contrib><contrib contrib-type="author"><name><surname>Vehreschild</surname><given-names>Jörg J</given-names></name><xref ref-type="aff" rid="dys164-AFF1"><sup>24</sup></xref></contrib><contrib contrib-type="author"><name><surname>Sterne</surname><given-names>Jonathan AC</given-names></name><xref ref-type="aff" rid="dys164-AFF1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><collab>the Antiretroviral Therapy Cohort Collaboration (ART-CC)</collab><xref ref-type="author-notes" rid="dys164-FN1">†</xref></contrib></contrib-group><aff id="dys164-AFF1"><sup>1</sup>School of Social and Community Medicine, University of Bristol, Bristol, UK,<sup>2</sup>Division of Epidemiology and Population Health, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada,<sup>3</sup>Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada,<sup>4</sup>Center for Interdisciplinary Research on AIDS, Yale University School of Medicine, New Haven, CT, USA,<sup>5</sup>VA Connecticut Healthcare System, West Haven, CT, USA,<sup>6</sup>Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, TN, USA,<sup>7</sup>INSERM, U943, F-75013 Paris, France,<sup>8</sup>UPMC University Paris 06, UMR S943, F-75013 Paris, France,<sup>9</sup>AP-HP, Groupe hospitalier Pitié-Salpêtrière, Service de Maladies Infectieuses et Tropicales, F-75013 Paris, France,<sup>10</sup>Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Switzerland,<sup>11</sup>University Bordeaux, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, F-33000 Bordeaux, France,<sup>12</sup>INSERM, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, F-33000 Bordeaux, France,<sup>13</sup>Division of Infectious Diseases, University of Calgary, Calgary, Canada,<sup>14</sup>Copenhagen HIV Programme, Panum Institute, University of Copenhagen, Denmark,<sup>15</sup>Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark,<sup>16</sup>Stichting HIV Monitoring, Amsterdam, The Netherlands,<sup>17</sup>Division of Infectious Disease, Department of Medicine, University of Alabama, Birmingham, AL, USA,<sup>18</sup>Infectious Diseases Program, Corporació Sanitària Parc Taulí, Sabadell, Barcelona, Spain,<sup>19</sup>Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain,<sup>20</sup>Research Department of Infection and Population Health, UCL Medical School, London, UK,<sup>21</sup>HIV Atlanta VA Cohort Study (HAVACS), Atlanta Veterans Affairs Medical Center, Decatur, GA, USA,<sup>22</sup>University of Washington School of Medicine, Seattle, WA, USA,<sup>23</sup>Clinic of Infectious Diseases and Tropical Medicine, San Paolo Hospital, University of Milan, Italy and<sup>24</sup>First Department of Internal Medicine, University Hospital of Cologne, Cologne, Germany</aff><author-notes><corresp id="dys164-COR1">*Corresponding author. School of Social and Community
Medicine, Canynge Hall, 39 Whatley Road, University of Bristol, Bristol, BS8 2PS, UK.
E-mail: <email>m.t.may@bristol.ac.uk</email></corresp><fn id="dys164-FN1"><p><sup>†</sup>The members of the Antiretroviral Therapy Cohort Collaboration
(ART-CC) are provided in the Supplementary Appendix.</p></fn></author-notes><pub-date pub-type="ppub"><month>12</month><year>2012</year></pub-date><pub-date pub-type="epub"><day>10</day><month>11</month><year>2012</year></pub-date><pub-date pub-type="pmc-release"><day>1</day><month>12</month><year>2013</year></pub-date><pmc-comment> PMC Release delay is 12 months and 0 days and was based on the
<volume>41</volume><issue>6</issue><fpage>1807</fpage><lpage>1820</lpage><history><date date-type="accepted"><day>23</day><month>8</month><year>2012</year></date></history><permissions><copyright-statement>Published by Oxford University Press on behalf of the International
Epidemiological Association © The Author 2012; all rights
reserved.</copyright-statement><copyright-year>2012</copyright-year></permissions><abstract><p><bold>Background</bold> HIV cohort collaborations, which pool data from diverse patient
cohorts, have provided key insights into outcomes of antiretroviral therapy (ART).
However, the extent of, and reasons for, between-cohort heterogeneity in rates of AIDS and
mortality are unclear.</p><p><bold>Methods</bold> We obtained data on adult HIV-positive patients who started ART from
1998 without a previous AIDS diagnosis from 17 cohorts in North America and Europe.
Patients were followed up from 1 month to 2 years after starting ART. We examined
between-cohort heterogeneity in crude and adjusted (age, sex, HIV transmission risk, year,
CD4 count and HIV-1 RNA at start of ART) rates of AIDS and mortality using random-effects
meta-analysis and meta-regression.</p><p><bold>Results</bold> During 61 520 person-years, 754/38 706 (1.9%) patients died
and 1890 (4.9%) progressed to AIDS. Between-cohort variance in mortality rates was
reduced from 0.84 to 0.24 (0.73 to 0.28 for AIDS rates) after adjustment for patient
characteristics. Adjusted mortality rates were inversely associated with cohorts’
estimated completeness of death ascertainment [excellent: 96–100%, good:
90–95%, average: 75–89%; mortality rate ratio 0.66 (95%
confidence interval 0.46–0.94) per category]. Mortality rate ratios comparing Europe
with North America were 0.42 (0.31–0.57) before and 0.47 (0.30–0.73) after
adjusting for completeness of ascertainment.</p><p><bold>Conclusions</bold> Heterogeneity between settings in outcomes of HIV treatment has
implications for collaborative analyses, policy and clinical care. Estimated mortality
rates may require adjustment for completeness of ascertainment. Higher mortality rate in
North American, compared with European, cohorts was not fully explained by completeness of
ascertainment and may be because of the inclusion of more socially marginalized patients
with higher mortality risk.</p></abstract><kwd-group><kwd>HIV</kwd><kwd>AIDS</kwd><kwd>antiretroviral therapy</kwd><kwd>mortality</kwd><kwd>cohort</kwd><kwd>heterogeneity</kwd><kwd>prognostic model</kwd><kwd>socio-economic status</kwd></kwd-group><counts><page-count count="14"></page-count></counts></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Sante/explor/SidaSubSaharaV1/Data/Pmc/Corpus
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 001685 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Pmc/Corpus/biblio.hfd -nk 001685 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Wicri/Sante
|area= SidaSubSaharaV1
|flux= Pmc
|étape= Corpus
|type= RBID
|clé= PMC:3535877
|texte= Heterogeneity in outcomes of treated HIV-positive patients in Europe and
North America: relation with patient and cohort characteristics
}}
Pour générer des pages wiki
HfdIndexSelect -h $EXPLOR_AREA/Data/Pmc/Corpus/RBID.i -Sk "pubmed:23148105" \
| HfdSelect -Kh $EXPLOR_AREA/Data/Pmc/Corpus/biblio.hfd \
| NlmPubMed2Wicri -a SidaSubSaharaV1
| This area was generated with Dilib version V0.6.32. |  |