Information de reference pour ce titreAccession Number: | 00126334-201808150-00011.
|
Author: | Novitsky, Vlad MD, PhD *,+; Gaolathe, Tendani MD *; Mmalane, Mompati MD, FRCS, MSc *; Moyo, Sikhulile MSc, MPH, PhD *; Chakalisa, Unoda MD *; Yankinda, Etienne Kadima MPH *; Marukutira, Tafireyi MPH ++; Holme, Molly Pretorius MS +; Sekoto, Tumalano BA *; Gaseitsiwe, Simani PhD *,+; Musonda, Rosemary MSc, PhD *,+; van Widenfelt, Erik BA *; Powis, Kathleen M. MD *,+,[S],[forms double vertical]; Khan, Nealia MPH +; Dryden-Peterson, Scott MD, MSc *,+,[P]; Bennett, Kara MS #; Wirth, Kathleen E. ScD +,**; Tchetgen, Eric Tchetgen PhD **,++; Bachanas, Pam PhD ++++; Mills, Lisa A. MD, MSc ++; Lebelonyane, Refeletswe MPH [S][S]; el-Halabi, Shenaaz MPH [S][S]; Makhema, Joseph MBBS, FRCP *,+; Lockman, Shahin MD *,+,[forms double vertical],[P]; Essex, M. DVM, PhD *,+
|
Institution: | (*)Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana; (+)Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA; (++)Division of Global HIV/AIDS, Centers for Disease Control and Prevention, Gaborone, Botswana; ([S])Departments of Medicine and Pediatrics, Massachusetts General Hospital, Boston, MA; ([forms double vertical])Department of Medicine, Harvard Medical School, Boston, MA; ([P])Division of Infectious Diseases, Brigham and Women's Hospital, Boston, MA; (#)Bennett Statistical Consulting, Inc, Ballston Lake, NY; Departments of (**)Epidemiology; (++)Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA; (++++)Division of Global HIV/AIDS, Centers for Disease Control and Prevention, Atlanta, GA; and ([S][S])Ministry of Health and Wellness, Republic of Botswana, Gaborone, Botswana.
|
Title: | |
Source: | JAIDS Journal of Acquired Immune Deficiency Syndromes. 78(5):557-565, August 15, 2018.
|
Abstract: | Background: HIV-1 RNA load is the best biological predictor of HIV transmission and treatment response. The rate of virologic suppression among key subpopulations can guide HIV prevention programs.
Methods: The Botswana Combination Prevention Project performed a population-based household survey among adults in 30 communities in Botswana. Data collected included knowledge of HIV-positive status, antiretroviral therapy (ART) coverage, and virologic suppression (HIV-1 RNA <=400 copies per milliliter). Individuals aged 16-29 years were considered young adults.
Results: Among 552 young people living with HIV enrolled with RNA load data and ART status available, 51% (n = 279) had undetectable HIV-1 RNA, including 54% of young women and 32% of young men [sex prevalence ratio (PR): 0.53; 95% confidence interval (CI): 0.43 to 0.80; P < 0.001]. Compared with older adults (30-64 years old), young HIV-infected adults were significantly less likely to have undetectable HIV-1 RNA (PR: 0.65; 95% CI: 0.59 to 0.70; P < 0.0001), including both men (PR: 0.43; 95% CI: 0.34 to 0.56; P < 0.0001) and women (PR: 0.67; 95% CI: 0.62 to 0.74; P < 0.0001). Among a subset of people living with HIV receiving ART, young adults also were less likely to have undetectable HIV-1 RNA load than older adults (PR: 0.93; 95% CI: 0.90 to 0.95; P = <0.0001). Analysis of the care continuum revealed that inferior HIV diagnosis and suboptimal linkage to care are the primary reasons for low virologic suppression among young adults.
Conclusions: Young adults in Botswana are significantly less likely to have undetectable HIV-1 RNA load compared with older adults. In the era of broad scale-up of ART, interventions able to diagnose young adults living with HIV and link them to effective therapy are urgently needed.
Copyright (C) 2018 Wolters Kluwer Health, Inc. All rights reserved.
|
Author Keywords: | HIV-1C epidemic; young adults; HIV suppression; receiving ART; virologically suppressed.
|
References: | 1. UNAIDS. The Gap Report. Available at: http://www.unaids.org/en/resourc...- ouverture dans une nouvelle fenêtre. 2014. Accessed November 14, 2017.
2. UNAIDS. Global Report. UNAIDS Report on the global AIDS epidemic 2013. Available at: http://files.unaids.org/en/media...- ouverture dans une nouvelle fenêtre. 2013. Accessed November 14, 2017.
3. UNAIDS. Global Aids Response Progress Reporting 2015. Available at: http://www.unaids.org/sites/defa...- ouverture dans une nouvelle fenêtre. 2015. Accessed November 14, 2017.
4. WHO. Guideline on When to START Antiretroviral Therapy and on Pre-exposure Prophylaxis for HIV. September 2015. Geneva, Switzerland: WHO; 2015. Available at: http://apps.who.int/iris/bitstre...- ouverture dans une nouvelle fenêtre. Accessed November 14, 2017.
5. UNAIDS. UNAIDS. 90-90-90: An Ambitious Treatment Target to Help End the Aids Epidemic. Geneva, Switzerland: UNAIDS; 2014. Available at: http://www.unaids.org/sites/defa...- ouverture dans une nouvelle fenêtre. Accessed November 14, 2017.
6. Statistics Botswana. Botswana Aids Impact Survey IV (BAIS IV), 2013. Summary Results. 2013.
7. Gaolathe T, Wirth K, Holme MP, et al. Botswana is close to meeting UNAIDS 2020 goals of 90-90-90 coverage. Paper presented at: CROI2016; February 22-25, 2016; Boston, MA. Abstract 16-1447.
8. Gaolathe T, Wirth KE, Holme MP, et al. Botswana's progress toward achieving the 2020 UNAIDS 90-90-90 antiretroviral therapy and virological suppression goals: a population-based survey. Lancet HIV. 2016;3:e221-230.
9. Moyo S, Boleo C, Mohammed T, et al. Cross-sectional HIV incidence at scale-up of ART in 24 rural communities in Botswana. Paper presented at: CROI2016; February 22-25, 2016; Boston, MA. Abstract 16-1126.
10. Moyo S, Mohammed T, Kotokwe K, et al. Cross-sectional estimates of HIV incidence remain high in rural communities in Botswana in the era of successful scale-up of ART. IAS; July 18-22, 2016; Durban, South Africa. Abstract TUPDC0103.
11. Celum CL, Delany-Moretlwe S, McConnell M, et al. Rethinking HIV prevention to prepare for oral PrEP implementation for young African women. J Int AIDS Soc. 2015;18(4 suppl 3):20227.
12. Abdool Karim SS, Abdool Karim Q, Baxter C. Antibodies for HIV prevention in young women. Curr Opin HIV AIDS. 2015;10:183-189.
13. Harrison A, Colvin CJ, Kuo C, et al. Sustained high HIV incidence in young women in Southern Africa: social, behavioral, and structural factors and emerging intervention approaches. Curr HIV/AIDS Rep. 2015;12:207-215.
14. UNAIDS. 90-90-90 on the right track towards the global target. 2016. Available at: https://reliefweb.int/sites/reli...- ouverture dans une nouvelle fenêtre. Accessed January 10, 2018.
15. Mujugira A, Celum C, Tappero JW, et al. Younger age predicts failure to achieve viral suppression and virologic rebound among HIV-1-infected persons in serodiscordant partnerships. AIDS Res Hum Retroviruses. 2016;32:148-154.
16. Mujugira A, Celum C, Thomas KK, et al. Delay of antiretroviral therapy initiation is common in East African HIV-infected individuals in serodiscordant partnerships. J Acquir Immune Defic Syndr. 2014;66:436-442.
17. Ryscavage P, Anderson EJ, Sutton SH, et al. Clinical outcomes of adolescents and young adults in adult HIV care. J Acquir Immune Defic Syndr. 2011;58:193-197.
18. Rosen S, Maskew M, Fox MP, et al. Rapid ART initiation reduces loss between HIV testing and treatment: the RapIT trial. Abstract 1091. CROI 2015; 2015.
19. Plazy M, Dray-Spira R, Orne-Gliemann J, et al. Continuum in HIV care from entry to ART initiation in rural KwaZulu-Natal, South Africa. Trop Med Int Health. 2014;19:680-689.
20. Botswana MoH. National guidelines. HIV testing and counseling. 2009. Available at: https://aidsfree.usaid.gov/sites...- ouverture dans une nouvelle fenêtre. Accessed December 16, 2017.
21. R: a language and environment for statistical computing [computer program]. Vienna, Austria: R Foundation for Statistical Computing; 2016. Available at: https://www.R-project.org/- ouverture dans une nouvelle fenêtre. Accessed January 20, 2018.
22. Ministry of Health Botswana. Botswana national HIV/AIDS treatment guidelines. 2012. Available at: http://www.med.upenn.edu/botswan...- ouverture dans une nouvelle fenêtre. Accessed January 20, 2018.
23. Mossong J, Grapsa E, Tanser F, et al. Modelling HIV incidence and survival from age-specific seroprevalence after antiretroviral treatment scale-up in rural South Africa. AIDS. 2013;27:2471-2479.
24. Wynn A, Ramogola-Masire D, Gaolebale P, et al. Acceptability and feasibility of sexually transmitted infection testing and treatment among pregnant women in Gaborone, Botswana, 2015. Biomed Res Int. 2016;2016:1251238.
25. Offorjebe OA, Wynn A, Moshashane N, et al. Partner notification and treatment for sexually transmitted infections among pregnant women in Gaborone, Botswana. Int J STD AIDS. 2017:28:1184-1189.
26. Dryden-Peterson S, Bennett K, Hughes MD, et al. An augmented SMS intervention to improve access to antenatal CD4 testing and ART initiation in HIV-infected pregnant women: a cluster randomized trial. PLoS One. 2015;10:e0117181.
27. Creek T, Ntumy R, Mazhani L, et al. Factors associated with low early uptake of a national program to prevent mother to child transmission of HIV (PMTCT): results of a survey of mothers and providers, Botswana, 2003. AIDS Behav. 2009;13:356-364.
28. Lockman S, Creek T. Acute maternal HIV infection during pregnancy and breast-feeding: substantial risk to infants. J Infect Dis. 2009;200:667-669.
29. Creek TL, Ntumy R, Seipone K, et al. Successful introduction of routine opt-out HIV testing in antenatal care in Botswana. J Acquir Immune Defic Syndr. 2007;45:102-107.
30. Zanoni B, Cairns C, Haberer J. High retention and viral suppression rates in a dedicated adolescent-friendly HIV clinic in South Africa. AIDS 2016-21st International AIDS Conference; July 18-22, 2016; Durban, South Africa. Abstract TUPEB124.
31. Griffith D, Keruly J, Lee L, et al. Impact of a youth-targeted HIV clinic integrated within a large urban adult clinic. AIDS 2016-21st International AIDS Conference; July 18-22, 2016; Durban, South Africa. Abstract TUPEB125.
32. Mark D, Ngombe A, Burford G, et al. Project REACH: a facility-based peer support model across 20 facilities in five sub-Saharan African countries. AIDS 2016-21st International AIDS Conference; July 18-22, 2016; Durban, South Africa. Abstract TUPEB126.
33. Matatiyo B, Likongwe D. A study of factors affecting male involvement in HIV-related services in Malawi. AIDS 2016-21st International AIDS Conference; July 18-22, 2016; Durban, South Africa. Abstract TUPED348.
34. Pascoe L, Peacock D. Where are the men? Addressing the global blind spot around heterosexual men in the HIV pandemic. AIDS 2016-21st International AIDS Conference; July 18-22, 2016; Durban, South Africa. Abstract TUPED425.
35. Crowell TA, Hatano H. Clinical outcomes and antiretroviral therapy in "elite" controllers: a review of the literature. J Virus Erad. 2015;1:72-77.
36. Walker BD. Elite control of HIV Infection: implications for vaccines and treatment. Top HIV Med. 2007;15:134-136.
37. Eyzaguirre LM, Charurat M, Redfield RR, et al. Elevated hypermutation levels in HIV-1 natural viral suppressors. Virology 2013;443:306-312.
38. Miura T, Brockman MA, Brumme CJ, et al. Genetic characterization of human immunodeficiency virus type 1 in elite controllers: lack of gross genetic defects or common amino acid changes. J Virol. 2008;82:8422-8430.
39. Miura T, Brumme ZL, Brockman MA, et al. Impaired replication capacity of acute/early viruses in persons who become HIV controllers. J Virol. 2010;84:7581-7591.
40. Kahle EM, Kashuba A, Baeten JM, et al. Unreported antiretroviral use by HIV-1-infected participants enrolling in a prospective research study. J Acquir Immune Defic Syndr. 2014;65:e90-94.
41. de Oliveira T, Kharsany AB, Graf T, et al. Transmission networks and risk of HIV infection in KwaZulu-Natal, South Africa: a community-wide phylogenetic study. Lancet HIV. 2017;4:e41-e50.
|
Language: | English.
|
Document Type: | Clinical Science.
|
Journal Subset: | Nursing. Clinical Medicine. Health Professions.
|
ISSN: | 1525-4135
|
DOI Number: | https://dx.doi.org/10.1097/QAI.0...- ouverture dans une nouvelle fenêtre
|
Annotation(s) | |
|
|