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Trends over calendar time in antiretroviral treatment success and failure in HIV clinic populations.
- Source :
-
HIV medicine [HIV Med] 2010 Aug; Vol. 11 (7), pp. 432-8. Date of Electronic Publication: 2010 Feb 08. - Publication Year :
- 2010
-
Abstract
- Objective: Effective antiretroviral therapy (ART) has transformed the care of people with HIV, but it is important to monitor time trends in indicators of treatment success and antic future changes.<br />Methods: We assessed time trends from 2000 to 2007 in several indicators of treatment success in the UK Collaborative HIV Cohort (CHIC) Study, and using national HIV data from the Health Protection Agency (HPA) we developed a model to project future trends.<br />Results: The proportion of patients on ART with a viral load <50 HIV-1 RNA copies/mL increased from 62% in 2000 to 84% in 2007, and the proportion of all patients with a CD4 count <200 cells/microL decreased from 21% to 10%. During this period, the number of patients who experienced extensive triple class failure (ETCF) rose from 147 (0.9%) to 1771 (3.9%). The number who experienced such ETCF and had a current viral load >50 copies/mL rose fromz 118 (0.7%) to 857 (1.9%). Projections to 2012 suggest sustained high levels of success, with a continued increase in the number of patients who have failed multiple drugs but a relatively stable number of such patients experiencing viral loads >50 copies/mL. Numbers of deaths are projected to remain low.<br />Conclusions: There have been continued improvements in key indicators of success in patients with HIV from 2000 to 2007. Although the number of patients who have ETCF is projected to rise in the future, the number of such patients with viral loads >50 copies/mL is not projected to increase up to 2012. New drugs may be needed in future to sustain these positive trends.
- Subjects :
- Ambulatory Care Facilities
Anti-HIV Agents administration & dosage
Anti-HIV Agents pharmacology
Cohort Studies
Drug Resistance, Multiple, Viral
Female
HIV Infections mortality
HIV Infections virology
HIV-1 genetics
Humans
Male
Middle Aged
Models, Theoretical
Stochastic Processes
Time Factors
Treatment Failure
United Kingdom
Viral Load
Anti-HIV Agents therapeutic use
Antiretroviral Therapy, Highly Active trends
Forecasting
HIV Infections drug therapy
HIV-1 drug effects
Outcome and Process Assessment, Health Care
Subjects
Details
- Language :
- English
- ISSN :
- 1468-1293
- Volume :
- 11
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- HIV medicine
- Publication Type :
- Academic Journal
- Accession number :
- 20146736
- Full Text :
- https://doi.org/10.1111/j.1468-1293.2009.00809.x