دورية أكاديمية
Beyond undetectable ; modeling the clinical benefit of improved antiretroviral adherence in persons with human immunodeficiency virus with virologic suppression
| العنوان: | Beyond undetectable ; modeling the clinical benefit of improved antiretroviral adherence in persons with human immunodeficiency virus with virologic suppression |
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| المؤلفون: | Castillo-Mancilla, Jose R., Morrow, Mary, Hunt, Peter W., Schnittman, Samuel R., Phillips, Andrew N., Baker, Jason V., Haberer, Jessica E., Janeiro, Maria Joao, Aragao, Filipa, Cohen, Cal, Musinguzi, Nicholas, Brown, Todd T., Cavassini, Matthias, Glass, Tracy R., Serrano-Villar, Sergio, Mawhinney, Samantha, Siedner, Mark |
| المساهمون: | Comprehensive Health Research Centre (CHRC) - Pólo ENSP, Centro de Investigação em Saúde Pública (CISP/PHRC), Escola Nacional de Saúde Pública (ENSP) |
| سنة النشر: | 2023 |
| المجموعة: | Repositório da Universidade Nova de Lisboa (UNL) |
| مصطلحات موضوعية: | adherence, coagulopathy, HIV, inflammation, viral suppression, Oncology, Infectious Diseases, SDG 3 - Good Health and Well-being |
| الوصف: | Funding Information: Financial support. This work was supported by the National Institutes of Health (grant numbers R01AI145453 to J. R. C.-M. and T32AI007387 to S. R. S.). Publisher Copyright: © 2023 The Author(s). Published by Oxford University Press on behalf of Infectious Diseases Society of America. ; Background: Incomplete antiretroviral therapy (ART) adherence has been linked to deleterious immunologic, inflammatory, and clinical consequences, even among virally suppressed (<50 copies/mL) persons with human immunodeficiency virus (PWH). The impact of improving adherence in the risk of severe non-AIDS events (SNAEs) and death in this population is unknown. Methods: We estimated the reduction in the risk of SNAEs or death resulting from an increase in ART adherence by (1) applying existing data on the association between adherence with high residual inflammation/coagulopathy in virally suppressed PWH, and (2) using a Cox proportional hazards model derived from changes in plasma interleukin 6 (IL-6) and D-dimer from 3 randomized clinical trials. Comparatively, assuming 100% ART adherence in a PWH who achieves viral suppression, we estimated the number of persons in whom a decrease in adherence to <100% would need to be observed for an additional SNAE or death event to occur during 3- and 5-year follow-up. Results: Increasing ART adherence to 100% in PWH who are suppressed on ART despite imperfect adherence translated into a 6%-37% reduction in the risk of SNAEs or death. Comparatively, based on an anticipated 12% increase in IL-6, 254 and 165 PWH would need to decrease their adherence from 100% to <100% for an additional event to occur over 3- and 5-year follow-up, respectively. Conclusions: Modest gains in ART adherence could have clinical benefits beyond virologic suppression. Increasing ART adherence (eg, via an intervention or switch to long-acting ART) in PWH who remain virally suppressed despite incomplete adherence should be evaluated. ; publishersversion ; published |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| ردمك: | 978-85-16-08074-7 978-0-00-991074-6 85-16-08074-9 0-00-991074-3 |
| تدمد: | 2328-8957 |
| العلاقة: | PURE: 66570292; PURE UUID: bee91b21-1d19-4829-8bd6-b81c33f57d53; Scopus: 85160807499; WOS: 000991074300001; PubMed: 37213424; PubMedCentral: PMC10199113; http://hdl.handle.net/10362/155427Test; https://doi.org/10.1093/ofid/ofad230Test |
| DOI: | 10.1093/ofid/ofad230 |
| الإتاحة: | https://doi.org/10.1093/ofid/ofad230Test http://hdl.handle.net/10362/155427Test |
| حقوق: | openAccess |
| رقم الانضمام: | edsbas.B7728F |
| قاعدة البيانات: | BASE |
Full Text Finder | ردمك: | 9788516080747 9780009910746 8516080749 0009910743 |
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| تدمد: | 23288957 |
| DOI: | 10.1093/ofid/ofad230 |