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Expanded HAART coverage is associated with decreased population-level HIV-1-RNA and annual new HIV diagnoses in British Columbia, Canada Montaner, Julio; Lima, Viviane Dias; Barrios, Rolando; Yip, Benita; Wood, Evan; Kerr, Thomas; Shannon, K.; Harrigan, Paul Richard; Hogg, Robert S.; Daly, Patricia; Kendall, Perry R. W. (Perry Robert William), 1943-

Abstract

Background—Cohort studies and mathematical models have suggested that expanded coverage with highly active antiretroviral therapy (HAART) could decrease HIV transmission. This study focuses on the HIV epidemic, stratified by injection drug use, in the province of British Columbia, Canada, and seeks to estimate the association between plasma HIV-1-viral load, HAART coverage and number of new cases of HIV at the population-level. Methods—HAART use, plasma HIV-1-viral level determinations, and rates of reportable sexually transmitted infections, including HIV, are all recorded in province-wide registries allowing for temporal comparisons of these parameters. Trends of new HIV positive tests and number of individuals on HAART were modeled using generalized additive models. Poisson loglinear regression models were used to estimate the association between the outcome new HIV positive tests (per 100 population) and the covariates viral load (log10 transformed), year, and number of individuals on HAART. Conclusions—Our results demonstrate a strong association at the population-level between increasing levels of HAART coverage, decreased viral load and decreased new HIV diagnoses/ year, against a background of increased HIV testing and increased rates of other STIs in the province. Our results support the proposed secondary benefit of HAART, used within current medical guidelines, on HIV transmission at a population level.

Item Metadata

Title
Expanded HAART coverage is associated with decreased population-level HIV-1-RNA and annual new HIV diagnoses in British Columbia, Canada
Creator
Montaner, Julio; Lima, Viviane Dias; Barrios, Rolando; Yip, Benita; Wood, Evan; Kerr, Thomas; Shannon, K.; Harrigan, Paul Richard; Hogg, Robert S.; Daly, Patricia; Kendall, Perry R. W. (Perry Robert William), 1943-
Contributor
British Columbia Centre for Excellence in HIV/AIDS
Date Issued
2010-08
Description
Background—Cohort studies and mathematical models have suggested that expanded coverage with highly active antiretroviral therapy (HAART) could decrease HIV transmission. This study focuses on the HIV epidemic, stratified by injection drug use, in the province of British Columbia, Canada, and seeks to estimate the association between plasma HIV-1-viral load, HAART coverage and number of new cases of HIV at the population-level. Methods—HAART use, plasma HIV-1-viral level determinations, and rates of reportable sexually transmitted infections, including HIV, are all recorded in province-wide registries allowing for temporal comparisons of these parameters. Trends of new HIV positive tests and number of individuals on HAART were modeled using generalized additive models. Poisson loglinear regression models were used to estimate the association between the outcome new HIV positive tests (per 100 population) and the covariates viral load (log10 transformed), year, and number of individuals on HAART. Conclusions—Our results demonstrate a strong association at the population-level between increasing levels of HAART coverage, decreased viral load and decreased new HIV diagnoses/ year, against a background of increased HIV testing and increased rates of other STIs in the province. Our results support the proposed secondary benefit of HAART, used within current medical guidelines, on HIV transmission at a population level.
Geographic Location
Downtown-Eastside (Vancouver, B.C.)
Genre
Article; Postprint
Type
Text
Language
eng
Date Available
2018-08-03
Provider
Vancouver : University of British Columbia Library
Rights
Attribution-NonCommercial-NoDerivatives 4.0 International
DOI
10.14288/1.0369294
URI
http://hdl.handle.net/2429/66665
Affiliation
Medicine, Faculty of; Other UBC; Non UBC; Medicine, Department of
Citation
Montaner, J. S. G., Lima, V. D., Barrios, R., Yip, B., Wood, E., Kerr, T., … Kendall, P. (2010). Expanded HAART Coverage is Associated with Decreased Population-level HIV-1-RNA and Annual New HIV Diagnoses in British Columbia, Canada. Lancet, 376(9740), 532–539.
Publisher DOI
10.1016/S0140-6736(10)60936-1
Peer Review Status
Reviewed
Scholarly Level
Faculty; Researcher; Unknown
Rights URI
http://creativecommons.org/licenses/by-nc-nd/4.0/
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Attribution-NonCommercial-NoDerivatives 4.0 International