Expanded HAART Coverage is Associated with Decreased Population-level HIV-1-RNA and Annual New HIV Diagnoses in British Columbia, Canada
By J. Montaner, V. Lima, Rolando Barrios, B. Yip, Evan Wood, Thomas Kerr, Kate Shannon, P. Harrigan, Robert S. Hogg, P. Daly and 1 more. The Lancet, 2010
762 citations recorded by the source corpus.
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 log-linear 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.
Subfields: Infectious Diseases, Virology
View Paper: https://www.semanticscholar.org/paper/913fd2f9619b69d18f34262335b3a8441b1fa52f
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Citations in the corpus
- Antiretroviral treatment of adult HIV infection: 2012 recommendations of the International Antiviral Society-USA panel. (2012, background): “Several communities with high ART use have observed an association between reduced “community viral loads” and lower rates of new infections.(24,25) The use of HIV treatment as prevention addresses an important public health objective, especially in the absence of a vaccine or additional inexpensive”
- Closing the Gap: Increases in Life Expectancy among Treated HIV-Positive Individuals in the United States and Canada (2013, background): “ART is effective in increasing the life span of HIV-positive individuals [2] and is associated with a reduction in new infections [4–6].”
- Antiretroviral Prophylaxis for HIV-1 Prevention among Heterosexual Men and Women (2012, neutral): “(%)¶** 59/1569 (4) 73/1576 (5) 60/1572 (4) 52/1573 (3) 62/1569 (4) 73/1571 (5)”