4.4 Article

Survival following HIV infection of a cohort followed up from seroconversion in the UK

Journal

AIDS
Volume 22, Issue 1, Pages 89-95

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/QAD.0b013e3282f3915e

Keywords

cohort study; highly active antiretroviral therapy; HIV seroconversion; survival

Funding

  1. Medical Research Council [MC_U122886351] Funding Source: Medline
  2. MRC [MC_U122886351] Funding Source: UKRI
  3. Medical Research Council [MC_U122886351] Funding Source: researchfish

Ask authors/readers for more resources

objectives: To estimate changes over calendar time in survival following HIV seroconversion in the era of HAART and to provide updated survival estimates. Methods: Using data from a UK cohort of persons with well estimated dates of HIV seroconversion, we analysed time from seroconversion to death from any cause using Cox models, adjusted for prognostic factors. Kaplan-Meier methods were then used to determine the expected survival in each calendar period. Results: 2275 seroconverters were included with 18 695 person-years of follow up. A total of 444 (20%) died. The relative risk of death, compared with pre-1996, decreased over time to 0.63 [95% confidence interval (Cl), 0.48-0.811, 0.24 (0.17-0.34), 0.14 (0.10-0.21), 0.08 (0.05-0.13) and 0.03 (0.02-0.06) in 1996-1997, 1998-1999, 2000-2001, 2002-2003 and 2004-2006, respectively. An elevated risk of death was associated with older age at seroconversion [hazard ratio (HR), 1.49; 95% Cl, 1.34-1.66 per 10-year increase] and HIV infection through injecting drug use (HR, 1.53; 95% Cl, 1.17-2.00). In 2000-2006, the proportion of individuals expected to survive 5, 10 and 15 years following seroconversion was 99%, 94% and 89%, respectively. Conclusions: Survival following HIV seroconversion has continued to improve over calendar time in our cohort, even in the more recent years of HAART availability. HIV seroconverters, by definition identified early in their infection, are likely to have the greatest opportunity for intervention; if similar high survival expectations are to be seen in the wider HIV-infected population, early diagnosis is likely to be crucial. (c) 2008 Wolters Kluwer Health.

Authors

I am an author on this paper
Click your name to claim this paper and add it to your profile.

Reviews

Primary Rating

4.4
Not enough ratings

Secondary Ratings

Novelty
-
Significance
-
Scientific rigor
-
Rate this paper

Recommended

Article Immunology

Booster Vaccination Against SARS-CoV-2 Induces Potent Immune Responses in People With Human Immunodeficiency Virus (HIV)

Sarah Fidler, Julie Fox, Timothy Tipoe, Stephanie Longet, Tom Tipton, Movin Abeywickrema, Sandra Adele, Jasmini Alagaratnam, Mohammad Ali, Parvinder K. Aley, Suhail Aslam, Anbhu Balasubramanian, Anna Bara, Tanveer Bawa, Anthony Brown, Helen Brown, Federica Cappuccini, Sophie Davies, Jamie Fowler, Leila Godfrey, Anna L. Goodman, Kathrine Hilario, Carl-Philipp Hackstein, Moncy Mathew, Yama F. Mujadidi, Alice Packham, Claire Petersen, Emma Plested, Katrina M. Pollock, Maheshi N. Ramasamy, Hannah Robinson, Nicola Robinson, Patpong Rongkard, Helen Sanders, Teona Serafimova, Niamh Spence, Anele Waters, Danielle Woods, Panagiota Zacharopoulou, Eleanor Barnes, Susanna Dunachie, Philip Goulder, Paul Klenerman, Alan Winston, Adrian V. S. Hill, Sarah C. Gilbert, Miles Carroll, Andrew J. Pollard, Teresa Lambe, Ane Ogbe, John Frater

Summary: People with HIV on antiretroviral therapy and good CD4 T-cell counts can generate effective immune responses against SARS-CoV-2 after vaccination. A third vaccine dose can significantly enhance B- and T-cell immunity, including responses to known variants of concern.

CLINICAL INFECTIOUS DISEASES (2023)

Article Multidisciplinary Sciences

A population-based matched cohort study of major congenital anomalies following COVID-19 vaccination and SARS-CoV-2 infection

Clara Calvert, Jade Carruthers, Cheryl Denny, Jack Donaghy, Lisa E. M. Hopcroft, Leanne Hopkins, Anna Goulding, Laura Lindsay, Terry McLaughlin, Emily Moore, Bob Taylor, Maria Loane, Helen Dolk, Joan Morris, Bonnie Auyeung, Krishnan Bhaskaran, Cheryl L. Gibbons, Srinivasa Vittal Katikireddi, Maureen O'Leary, David McAllister, Ting Shi, Colin R. Simpson, Chris Robertson, Aziz Sheikh, Sarah J. Stock, Rachael Wood

Summary: This study using electronic health records from Scotland found no increased risk of congenital anomalies associated with COVID-19 vaccination or SARS-CoV-2 infection during early pregnancy.

NATURE COMMUNICATIONS (2023)

Article Medicine, General & Internal

Challenges in Estimating the Effectiveness of COVID-19 Vaccination Using Observational Data

William J. Hulme, Elizabeth Williamson, Elsie M. F. Horne, Amelia Green, Helen I. I. McDonald, Alex J. J. Walker, Helen J. J. Curtis, Caroline E. Morton, Brian MacKenna, Richard Croker, Amir Mehrkar, Seb Bacon, David Evans, Peter Inglesby, Simon Davy, Krishnan Bhaskaran, Anna Schultze, Christopher T. Rentsch, Laurie Tomlinson, Ian J. Douglas, Stephen J. W. Evans, Liam Smeeth, Tom Palmer, Ben Goldacre, Miguel A. Hernan, Jonathan A. C. Sterne

Summary: The COVID-19 vaccines were developed and evaluated through randomized trials, but important questions remain unanswered. Observational studies and target trial emulation can provide valuable insights, although potential biases need to be managed. This article presents two approaches to emulate target trials using observational data.

ANNALS OF INTERNAL MEDICINE (2023)

Article Infectious Diseases

Predictors of starting and stopping chemsex in men who have sex with men in England: findings from the AURAH2 prospective study

Robbie Hammond, Valentina Cambiano, Fiona C. Lampe, David Asboe, Amanda Clarke, Richard Gilson, Graham J. Hart, Ada Rose Miltz, Nneka Nwokolo, Anne M. Johnson, Andrew N. Phillips, Andrew Speakman, Gary Whitlock, Alison Rodger, Janey Sewell

Summary: A longitudinal study on 622 men who have sex with men (MSM) found that factors such as age, unemployment, smoking, recent condomless sex, recent STI, and postexposure prophylaxis (PEP) use were associated with starting chemsex. On the other hand, age over 40, condomless sex, and use of PEP and pre-exposure prophylaxis (PrEP) were associated with lower likelihood of stopping chemsex. These findings can help identify individuals at high risk of starting chemsex and provide an opportunity for sexual health services to intervene with risk reduction measures, especially PrEP.

SEXUALLY TRANSMITTED INFECTIONS (2023)

Article Public, Environmental & Occupational Health

Differential Risk of SARS-CoV-2 Infection by Occupation: Evidence from the Virus Watch prospective cohort study in England and Wales

Sarah Beale, Susan Hoskins, Thomas Byrne, Wing Lam Erica Fong, Ellen Fragaszy, Cyril Geismar, Jana Kovar, Annalan M. D. Navaratnam, Vincent Nguyen, Parth Patel, Alexei Yavlinsky, Anne Johnson, Martie Van Tongeren, Robert Aldridge, Andrew Hayward

Summary: This study investigated the differences in infection risk among occupational groups in England and Wales up to April 2022, taking into account potential confounders and pandemic phases. The results showed that nurses, doctors, carers, primary and secondary school teachers, and teaching support occupations had a higher risk of infection. However, the risk varied over different phases. Therefore, further research is needed to understand the workplace factors contributing to elevated risk.

JOURNAL OF OCCUPATIONAL MEDICINE AND TOXICOLOGY (2023)

Article Critical Care Medicine

Intravenous aviptadil and remdesivir for treatment of COVID-19-associated hypoxaemic respiratory failure in the USA (TESICO): a randomised, placebo-controlled trial

Samuel M. Brown, Christina E. Barkauskas, Birgit Grund, Shweta Sharma, Andrew N. Phillips, Lindsay Leither, Ithan Peltan, Michael Lanspa, Daniel L. Gilstrap, Ahmad Mourad, Kathleen Lane, Jeremy R. Beitler, Alexis L. Serra, Ivan Garcia, Eyad Almasri, Mohamed Fayed, Kinsley Hubel, Estelle S. Harris, Elizabeth A. Middleton, Macy A. G. Barrios, Kusum S. Mathews, Neha N. Goel, Samuel Acquah, Jarrod Mosier, Cameron Hypes, Elizabeth Salvagio Campbell, Akram Khan, Catherine L. Hough, Jennifer G. Wilson, Joseph E. Levitt, Abhijit Duggal, Siddharth Dugar, Andrew J. Goodwin, Charles Terry, Peter Chen, Sam Torbati, Nithya Iyer, Uriel S. Sandkovsky, Nicholas J. Johnson, Bryce R. H. Robinson, Michaela Matthay, Neil Raggarwal, Ivors Douglas, Jonathan Casey, Manuel Hache-Marliere, J. Georges Youssef, William Nkemdirim, Brad Leshnower, Omar Awan, Sonal Pannu, Darragh Shane O'Mahony, Prasad Manian, J. W. Awori Hayanga, Glenn W. Wortmann, Bruno M. Tomazini, Robert F. Miller, Jens-Ulrik Jensen, Daniel Murray, Nina A. Bickell, Jigna Zatakia, Sarah Burris, Elizabeth S. Higgs, Ven Natarajan, Robin L. Dewar, Adam Schechner, Nayon Kang, Alejandro Arenas-Pinto, Fleur Hudson, Adit A. Ginde, Wesley H. Self, Angela J. Rogers, Cathryn F. Oldmixon, Haley Morin, Adriana Sanchez, Amy C. Weintrob, Alexandre Biasi Cavalcanti, Anne Davis-Karim, Nicole Engen, Eileen Denning, B. Taylor Thompson, Annetine C. Gelijns, Virginia Kan, Victoria J. Davey, Jens Lundgren, Abdel G. Babiker, James Neaton, H. Clifford Lane

Summary: This study evaluated the efficacy of aviptadil in treating acute hypoxemic respiratory failure in COVID-19 patients. The results showed no significant difference in the primary efficacy outcome at day 90 compared to placebo, and there was also no significant difference in mortality between the two groups. The incidence of adverse events was similar in the aviptadil and placebo groups.

LANCET RESPIRATORY MEDICINE (2023)

Article Immunology

Beyond Undetectable: Modeling the Clinical Benefit of Improved Antiretroviral Adherence in Persons With Human Immunodeficiency Virus With Virologic Suppression

Jose R. Castillo-Mancilla, Mary Morrow, Peter W. Hunt, Samuel R. Schnittman, Andrew N. Phillips, Jason Baker, Jessica E. Haberer, Maria Joao Janeiro, Filipa Aragao, Cal Cohen, Nicholas Musinguzi, Todd T. Brown, Matthias Cavassini, Tracy R. Glass, Sergio Serrano-Villar, Samantha Mawhinney, Mark Siedner

Summary: Incomplete antiretroviral therapy (ART) adherence has been linked to adverse outcomes in people with HIV. The impact of improving adherence on the risk of severe non-AIDS events (SNAEs) and death is unknown.

OPEN FORUM INFECTIOUS DISEASES (2023)

Article Infectious Diseases

Understanding experiences of potential harm among MSM (cis and trans) using HIV self-testing in the SELPHI randomised controlled trial in England and Wales: a mixed-methods study

T. Charles Witzel, Emily Jay Nicholls, Leanne McCabe, Peter Weatherburn, Sheena McCormack, Christopher Bonell, Mitzy Gafos, Fiona C. Lampe, Andrew Speakman, David Dunn, Denise Ward, Andrew N. Phillips, Roger Pebody, Michelle M. Gabriel, Yolanda Collaco-Moraes, Alison J. Rodger, Fiona M. Burns

Summary: This study investigates the relationship between HIV self-testing (HIVST) and harm. The findings show that harms in HIVST are rare, with the potential sources of harm being the testing kit itself, the intervention measures, or the social context of the participants.

SEXUALLY TRANSMITTED INFECTIONS (2023)

Article Multidisciplinary Sciences

Neonatal and maternal outcomes following SARS-CoV-2 infection and COVID-19 vaccination: a population-based matched cohort study

Laura Lindsay, Clara Calvert, Ting Shi, Jade Carruthers, Cheryl Denny, Jack Donaghy, Lisa E. M. Hopcroft, Leanne Hopkins, Anna Goulding, Terry Mclaughlin, Emily Moore, Bob Taylor, Krishnan Bhaskaran, Srinivasa Vittal Katikireddi, Ronan Mccabe, Colin Mccowan, Colin R. Simpson, Chris Robertson, Aziz Sheikh, Rachael Wood, Sarah J. Stock

Summary: This study investigates the impact of SARS-CoV-2 infection and COVID-19 vaccination during pregnancy on neonatal and maternal outcomes. The findings suggest that infection is associated with adverse outcomes such as preterm birth and maternal morbidity, while vaccination does not increase the risk of any adverse outcomes. Therefore, COVID-19 vaccination is considered safe for pregnant women.

NATURE COMMUNICATIONS (2023)

Article Oncology

Trends in Cancer Incidence in Different Antiretroviral Treatment-Eras amongst People with HIV

Lauren Greenberg, Lene Ryom, Elzbieta Bakowska, Ferdinand C. Wit, Heiner C. L. Bucher, Dominique L. Braun, Andrew Phillips, Caroline Sabin, Antonella d'Arminio Monforte, Robert Zangerle, Colette Smith, Stephane De Wit, Fabrice Bonnet, Christian Pradier, Cristina Mussini, Camilla Muccini, Joerg J. Vehreschild, Jennifer Hoy, Veronica M. Svedhem, Jose M. Miro, Jan-Christian Wasmuth, Peter M. Reiss, Josep M. Llibre, Nikoloz Chkhartishvili, Christoph I. Stephan, Camilla Hatleberg, Bastian Neesgaard, Lars Peters, Nadine Jaschinski, Nikos Dedes, Elena Kuzovatova, Marc Van Der Valk, Marianna Menozzi, Clara Lehmann, Kathy Petoumenos, Harmony Garges, Jim Rooney, Lital D. Young, Jens D. Lundgren, Loveleen Bansi-Matharu, Amanda Mocroft, RESPOND D A D Study Grp

Summary: Cancer incidence rates remained stable overall from 2006 to 2021, but there were changes in the rates of specific types of cancer among people with HIV. AIDS-defining cancers and infection-related cancers decreased, while non-AIDS-defining cancers, smoking-related cancers, and BMI-related cancers increased. These findings emphasize the importance of prevention strategies for reducing the incidence of non-AIDS-defining cancers, smoking-related cancers, and BMI-related cancers.

CANCERS (2023)

Article Health Care Sciences & Services

Sex-specific risks for cardiovascular disease across the glycaemic spectrum: a population-based cohort study using the UK Biobank

Christopher T. Rentsch, Victoria Gar, Rohini Mathur, Sophie V. Eastwood, Liam Smeeth, Nish Chaturvedi, Krishnan Bhaskaran

Summary: Sex-specific risks for incident cardiovascular disease (CVD) across the full glycemic spectrum were examined. Both men and women with pre-diabetes, undiagnosed diabetes, and diagnosed diabetes were at higher risks of CVD than those with normal glycated hemoglobin (HbA1c), with relative increases more pronounced in women. Modifiable factors, such as obesity and the use of antihypertensive and statin medications, largely explained the excess risks in both men and women. Attention to weight reduction strategies and greater use of antihypertensive and statin medications could reduce sex disparities in risk of CVD among people with and without diabetes.

LANCET REGIONAL HEALTH-EUROPE (2023)

Article Public, Environmental & Occupational Health

Use of point-of-care C-reactive protein testing for screening of tuberculosis in the community in high-burden settings: a prospective, cross-sectional study in Zambia and South Africa

Maria Ruperez, Kwame Shanaube, Linda Mureithi, Chali Wapamesa, Michael J. Burnett, Barry Kosloff, Petra de Haas, Richard Hayes, Sarah Fidler, Thomas Gachie, Albertus Schaap, Sian Floyd, Eveline Klinkenberg, Helen Ayles

Summary: This study aimed to evaluate the performance of a point-of-care C-reactive protein test for tuberculosis screening in high-burden countries. By conducting a tuberculosis prevalence survey, we calculated the sensitivity and specificity of C-reactive protein testing combined with symptom screening. The results showed that C-reactive protein testing alone does not meet the sensitivity requirement of 90% stipulated by WHO, but when combined with symptom screening, it may improve the identification of individuals with tuberculosis in communities with high prevalence, especially where recommended tools are not readily available.

LANCET GLOBAL HEALTH (2023)

Article Multidisciplinary Sciences

Therapeutic vaccination following early antiretroviral therapy elicits highly functional T cell responses against conserved HIV-1 regions

Jakub Kopycinski, Hongbing Yang, Gemma Hancock, Matthew Pace, Ellen Kim, John Frater, Wolfgang Stohr, Tomas Hanke, Sarah Fidler, Lucy Dorrell

Summary: The "kick and kill" cure strategy aims to eliminate HIV-infected cells by inducing HIV protein expression and triggering immune responses. In a trial involving individuals with primary HIV infection, therapeutic vaccination along with antiretroviral therapy showed increased virus-specific immune responses, similar to those seen in HIV controllers.

SCIENTIFIC REPORTS (2023)

Article Public, Environmental & Occupational Health

Cultural Adaption, Translation, Preliminary Reliability and Validity of Key Psychological and Behavioural Measures for 18 to 25 Year-Olds Living with HIV in Uganda: A Multi-Stage Approach

Michael Evangeli, Caroline Foster, Victor Musiime, Sarah Fidler, Janet Seeley, Graham Frize, Annette Uwizera, Joseph Price

Summary: HIV remains a significant public health issue among young adults living in Uganda. This study aimed to develop reliable and valid measures for assessing psychological and behavioral constructs related to important outcomes for this population. The measures showed acceptable reliability, and some had preliminary evidence of validity, suggesting their potential use in research and clinical contexts for young adults living with perinatally acquired HIV in Uganda.

AIDS AND BEHAVIOR (2023)

Article Health Policy & Services

Prevalence of pain in women living with HIV aged 45-60: associated factors and impact on patient-reported outcomes

Caroline A. Sabin, Hajra Okhai, Rageshri Dhairyawan, Katharina Haag, Fiona Burns, Richard Gilson, Lorraine Sherr, Shema Tariq

Summary: As women with HIV age, the proportion of them experiencing menopause and associated pain is increasing. This study found that peri-menopausal status, smoking, comorbid conditions, and longer duration of HIV were independently associated with increased reported pain, while being in full-time work and having enough money for basic needs were associated with decreased pain reporting. Increasing pain was also related to insomnia symptoms and severe depressive symptoms. The findings emphasize the importance of addressing pain history and symptoms to improve overall well-being.

AIDS CARE-PSYCHOLOGICAL AND SOCIO-MEDICAL ASPECTS OF AIDS/HIV (2023)

No Data Available