SidaSubSaharaV1, Pmc, Corpus, bibRecord, 001D66

A longitudinal, HIV care continuum: 10-year restricted mean time in each care continuum stage after enrollment in care, by history of injection drug use

Identifieur interne : 001D66 ( Pmc/Corpus ); précédent : 001D65; suivant : 001D67

A longitudinal, HIV care continuum: 10-year restricted mean time in each care continuum stage after enrollment in care, by history of injection drug use

Auteurs : Catherine R. Lesko ; Jessie K. Edwards ; Richard D. Moore ; Bryan Lau

Source :

AIDS (London, England) [ 0269-9370 ] ; 2016.

RBID : PMC:5063502

Abstract

Objectives

We present a novel, patient-centric, longitudinal summary of patient progress through the HIV care continuum. Using this new approach, we compare person-time spent alive, in care, on antiretroviral therapy (ART) and virally suppressed among persons who inject drugs (PWID) and those who do not (non-IDU).

Design

Prospective clinical observational cohort study.

Methods

We followed ART-naïve patients with detectable HIV viral loads who enrolled in the Johns Hopkins HIV Clinical Cohort from enrollment until the occurrence of several care continuum-related milestones, including ART initiation and viral suppression, and until several care continuum-related failures, including loss-to-clinic (LTC) and death. We added and subtracted cumulative incidence curves to estimate the proportion of the cohort in each of seven continuum stages across the 10 years following enrollment in clinical care.

Results

PWID composed 32% of the study sample (n=1,443). Over ten years following enrollment in care, PWID and non-IDU spent only 23% and 37% of person-time in care, on ART and virally suppressed. PWID lost 8.9 more months of life compared to non-IDU and spent an additional 5.0 months on ART but not virally suppressed, and an additional 5.5 months in care but not on ART. There were not meaningful improvements in the 5-year restricted mean person-time differences comparing PWID to non-IDU across enrollment cohorts (2000-03, 2004-07, 2008-14).

Conclusions

Efforts to increase viral suppression among PWID should focus on increasing ART initiation and improving adherence to therapy.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5063502

DOI: 10.1097/QAD.0000000000001183
PubMed: 27314178
PubMed Central: 5063502

Links to Exploration step

PMC:5063502

Le document en format XML

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<author><name sortKey="Lesko, Catherine R" sort="Lesko, Catherine R" uniqKey="Lesko C" first="Catherine R." last="Lesko">Catherine R. Lesko</name>
<affiliation><nlm:aff id="A1"> Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Edwards, Jessie K" sort="Edwards, Jessie K" uniqKey="Edwards J" first="Jessie K." last="Edwards">Jessie K. Edwards</name>
<affiliation><nlm:aff id="A2"> Department of Epidemiology, University of North Carolina, Chapel Hill, NC</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Moore, Richard D" sort="Moore, Richard D" uniqKey="Moore R" first="Richard D." last="Moore">Richard D. Moore</name>
<affiliation><nlm:aff id="A1"> Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A3"> School of Medicine, Johns Hopkins University, Baltimore, MD</nlm:aff>
</affiliation>
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<author><name sortKey="Lau, Bryan" sort="Lau, Bryan" uniqKey="Lau B" first="Bryan" last="Lau">Bryan Lau</name>
<affiliation><nlm:aff id="A1"> Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A3"> School of Medicine, Johns Hopkins University, Baltimore, MD</nlm:aff>
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<idno type="pmc">5063502</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5063502</idno>
<idno type="RBID">PMC:5063502</idno>
<idno type="doi">10.1097/QAD.0000000000001183</idno>
<date when="2016">2016</date>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">A longitudinal, HIV care continuum: 10-year restricted mean time in each care continuum stage after enrollment in care, by history of injection drug use</title>
<author><name sortKey="Lesko, Catherine R" sort="Lesko, Catherine R" uniqKey="Lesko C" first="Catherine R." last="Lesko">Catherine R. Lesko</name>
<affiliation><nlm:aff id="A1"> Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Edwards, Jessie K" sort="Edwards, Jessie K" uniqKey="Edwards J" first="Jessie K." last="Edwards">Jessie K. Edwards</name>
<affiliation><nlm:aff id="A2"> Department of Epidemiology, University of North Carolina, Chapel Hill, NC</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Moore, Richard D" sort="Moore, Richard D" uniqKey="Moore R" first="Richard D." last="Moore">Richard D. Moore</name>
<affiliation><nlm:aff id="A1"> Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A3"> School of Medicine, Johns Hopkins University, Baltimore, MD</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Lau, Bryan" sort="Lau, Bryan" uniqKey="Lau B" first="Bryan" last="Lau">Bryan Lau</name>
<affiliation><nlm:aff id="A1"> Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A3"> School of Medicine, Johns Hopkins University, Baltimore, MD</nlm:aff>
</affiliation>
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<series><title level="j">AIDS (London, England)</title>
<idno type="ISSN">0269-9370</idno>
<idno type="eISSN">1473-5571</idno>
<imprint><date when="2016">2016</date>
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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Objectives</title>
<p id="P1">We present a novel, patient-centric, longitudinal summary of patient progress through the HIV care continuum. Using this new approach, we compare person-time spent alive, in care, on antiretroviral therapy (ART) and virally suppressed among persons who inject drugs (PWID) and those who do not (non-IDU).</p>
</sec>
<sec id="S2"><title>Design</title>
<p id="P2">Prospective clinical observational cohort study.</p>
</sec>
<sec id="S3"><title>Methods</title>
<p id="P3">We followed ART-naïve patients with detectable HIV viral loads who enrolled in the Johns Hopkins HIV Clinical Cohort from enrollment until the occurrence of several care continuum-related milestones, including ART initiation and viral suppression, and until several care continuum-related failures, including loss-to-clinic (LTC) and death. We added and subtracted cumulative incidence curves to estimate the proportion of the cohort in each of seven continuum stages across the 10 years following enrollment in clinical care.</p>
</sec>
<sec id="S4"><title>Results</title>
<p id="P4">PWID composed 32% of the study sample (n=1,443). Over ten years following enrollment in care, PWID and non-IDU spent only 23% and 37% of person-time in care, on ART and virally suppressed. PWID lost 8.9 more months of life compared to non-IDU and spent an additional 5.0 months on ART but not virally suppressed, and an additional 5.5 months in care but not on ART. There were not meaningful improvements in the 5-year restricted mean person-time differences comparing PWID to non-IDU across enrollment cohorts (2000-03, 2004-07, 2008-14).</p>
</sec>
<sec id="S5"><title>Conclusions</title>
<p id="P5">Efforts to increase viral suppression among PWID should focus on increasing ART initiation and improving adherence to therapy.</p>
</sec>
</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>
  <pmc-dir>properties manuscript</pmc-dir>
  <front><journal-meta><journal-id journal-id-type="nlm-journal-id">8710219</journal-id>
<journal-id journal-id-type="pubmed-jr-id">1493</journal-id>
<journal-id journal-id-type="nlm-ta">AIDS</journal-id>
<journal-id journal-id-type="iso-abbrev">AIDS</journal-id>
<journal-title-group><journal-title>AIDS (London, England)</journal-title>
</journal-title-group>
<issn pub-type="ppub">0269-9370</issn>
<issn pub-type="epub">1473-5571</issn>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">27314178</article-id>
<article-id pub-id-type="pmc">5063502</article-id>
<article-id pub-id-type="doi">10.1097/QAD.0000000000001183</article-id>
<article-id pub-id-type="manuscript">NIHMS816414</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>A longitudinal, HIV care continuum: 10-year restricted mean time in each care continuum stage after enrollment in care, by history of injection drug use</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>LESKO</surname>
<given-names>Catherine R.</given-names>
</name>
<xref ref-type="aff" rid="A1">a</xref>
</contrib>
<contrib contrib-type="author"><name><surname>EDWARDS</surname>
<given-names>Jessie K.</given-names>
</name>
<xref ref-type="aff" rid="A2">b</xref>
</contrib>
<contrib contrib-type="author"><name><surname>MOORE</surname>
<given-names>Richard D.</given-names>
</name>
<xref ref-type="aff" rid="A1">a</xref>
<xref ref-type="aff" rid="A3">c</xref>
</contrib>
<contrib contrib-type="author"><name><surname>LAU</surname>
<given-names>Bryan</given-names>
</name>
<xref ref-type="aff" rid="A1">a</xref>
<xref ref-type="aff" rid="A3">c</xref>
</contrib>
</contrib-group>
<aff id="A1"><label>a</label>
 Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD</aff>
<aff id="A2"><label>b</label>
 Department of Epidemiology, University of North Carolina, Chapel Hill, NC</aff>
<aff id="A3"><label>c</label>
 School of Medicine, Johns Hopkins University, Baltimore, MD</aff>
<author-notes><corresp id="CR1">Correspondence to: Catherine R. Lesko, 615 N Wolfe St., Baltimore, MD 21205, <email>clesko2@jhu.edu</email>
, 410-614-6517</corresp>
</author-notes>
<pub-date pub-type="nihms-submitted"><day>24</day>
<month>9</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="ppub"><day>10</day>
<month>9</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>10</day>
<month>9</month>
<year>2017</year>
</pub-date>
<volume>30</volume>
<issue>14</issue>
<fpage>2227</fpage>
<lpage>2234</lpage>
<pmc-comment>elocation-id from pubmed: 10.1097/QAD.0000000000001183</pmc-comment>
      <abstract><sec id="S1"><title>Objectives</title>
<p id="P1">We present a novel, patient-centric, longitudinal summary of patient progress through the HIV care continuum. Using this new approach, we compare person-time spent alive, in care, on antiretroviral therapy (ART) and virally suppressed among persons who inject drugs (PWID) and those who do not (non-IDU).</p>
</sec>
<sec id="S2"><title>Design</title>
<p id="P2">Prospective clinical observational cohort study.</p>
</sec>
<sec id="S3"><title>Methods</title>
<p id="P3">We followed ART-naïve patients with detectable HIV viral loads who enrolled in the Johns Hopkins HIV Clinical Cohort from enrollment until the occurrence of several care continuum-related milestones, including ART initiation and viral suppression, and until several care continuum-related failures, including loss-to-clinic (LTC) and death. We added and subtracted cumulative incidence curves to estimate the proportion of the cohort in each of seven continuum stages across the 10 years following enrollment in clinical care.</p>
</sec>
<sec id="S4"><title>Results</title>
<p id="P4">PWID composed 32% of the study sample (n=1,443). Over ten years following enrollment in care, PWID and non-IDU spent only 23% and 37% of person-time in care, on ART and virally suppressed. PWID lost 8.9 more months of life compared to non-IDU and spent an additional 5.0 months on ART but not virally suppressed, and an additional 5.5 months in care but not on ART. There were not meaningful improvements in the 5-year restricted mean person-time differences comparing PWID to non-IDU across enrollment cohorts (2000-03, 2004-07, 2008-14).</p>
</sec>
<sec id="S5"><title>Conclusions</title>
<p id="P5">Efforts to increase viral suppression among PWID should focus on increasing ART initiation and improving adherence to therapy.</p>
</sec>
</abstract>
<kwd-group><kwd>Competing risks</kwd>
<kwd>HIV care continuum</kwd>
<kwd>Injection drug use</kwd>
<kwd>Survival analysis</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
</record>

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A longitudinal, HIV care continuum: 10-year restricted mean time in each care continuum stage after enrollment in care, by history of injection drug use

A longitudinal, HIV care continuum: 10-year restricted mean time in each care continuum stage after enrollment in care, by history of injection drug use

Source :

Abstract

Links to Exploration step

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