Abstract:
BACKGROUND:Measures of CD4 T-cell count and HIV-1 plasma viral load before antiretroviral therapy are proxies for virulence. Whether these proxies are changing over time has implications for prevention and treatment. The aim of this study was to investigate those trends. METHODS:Data were derived from the Concerted Action on SeroConversion to AIDS and Death in Europe (CASCADE) collaboration of mainly European seroconverter cohorts. Longitudinal CD4 cell counts and plasma viral load measurements before the initiation of antiretroviral therapy or AIDS onset were analysed by use of linear or fractional polynomials mixed models adjusting for all available potential confounders. Calendar time effects were modelled through natural cubic splines. FINDINGS:15 875 individuals seroconverting from 1979 to 2008 fulfilled the inclusion criteria; 3215 (20·3%) were women; median follow-up was 31 months (IQR 14-62); dropout before starting antiretroviral therapy or AIDS onset was 8·1%. Estimated CD4 counts at seroconversion for a typical individual declined from about 770 cells per μL (95% CI 750-800) in the early 1980s to a plateau of about 570 cells per μL (555-585) after 2002. CD4 cell rate of loss increased up to 2002. Estimated set-point plasma viral loads increased from 4·05 log10 copies per mL (95% CI 3·98-4·12) in 1980 to 4·50 log10 copies per mL (4·45-4·54) in 2002 with a tendency of returning to lower loads thereafter. Results were similar when we restricted analyses to various subsets, including adjusting for plasma viral load assay, censored follow-up at 3 years, or used variations of the main statistical approach. INTERPRETATION:Our results provide strong indications of increased HIV-1 virulence and transmissibility during the course of the epidemic and a potential plateau effect after about 2002. FUNDING:European Union Seventh Framework Programme.
journal_name
Lancet HIVjournal_title
The lancet. HIVauthors
Pantazis N,Porter K,Costagliola D,De Luca A,Ghosn J,Guiguet M,Johnson AM,Kelleher AD,Morrison C,Thiebaut R,Wittkop L,Touloumi G,CASCADE Collaboration in EuroCoord.doi
10.1016/S2352-3018(14)00002-2subject
Has Abstractpub_date
2014-12-01 00:00:00pages
e119-26issue
3eissn
2405-4704issn
2352-3018pii
S2352-3018(14)00002-2journal_volume
1pub_type
杂志文章相关文献
Lancet HIV文献大全abstract:BACKGROUND:Incarceration provides an opportunity for engagement in HIV care but is associated with poor HIV treatment outcomes after release. We aimed to assess post-release linkage to HIV care (LTC) and the effect of transitional case management services. METHODS:To create a retrospective cohort of all adults with HI...
journal_title:The lancet. HIV
pub_type: 杂志文章
doi:10.1016/S2352-3018(17)30209-6
更新日期:2018-02-01 00:00:00
abstract:BACKGROUND:Switching from therapy based on a boosted protease inhibitor to bictegravir, emtricitabine, and tenofovir alafenamide could avoid drug interactions and unwanted side-effects in virologically suppressed adults with HIV-1 infection, while maintaining a high barrier to resistance and providing a simplified once...
journal_title:The lancet. HIV
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/S2352-3018(18)30091-2
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:Universal antiretroviral therapy (ART), as per the 2015 WHO recommendations, might reduce population HIV incidence. We investigated the effect of universal test and treat on HIV acquisition at population level in a high prevalence rural region of South Africa. METHODS:We did a phase 4, open-label, cluster r...
journal_title:The lancet. HIV
pub_type: 杂志文章,随机对照试验
doi:10.1016/S2352-3018(17)30205-9
更新日期:2018-03-01 00:00:00
abstract:BACKGROUND:ADVANCE compared the efficacy and safety of two antiretroviral first-line combinations (dolutegravir combined with emtricitabine and either tenofovir disoproxil fumarate or tenofovir alafenamide), with a third regimen (efavirenz combined with emtricitabine and tenofovir disoproxil fumarate) previously recomm...
journal_title:The lancet. HIV
pub_type: 杂志文章,随机对照试验
doi:10.1016/S2352-3018(20)30241-1
更新日期:2020-10-01 00:00:00
abstract::Despite considerable progress in paediatric HIV treatment and timely revision of global policies recommending the use of more effective and tolerable antiretroviral regimens, optimal antiretroviral formulations for infants, children, and adolescents remain limited. The Paediatric Antiretroviral Drug Optimization group...
journal_title:The lancet. HIV
pub_type: 杂志文章,评审
doi:10.1016/S2352-3018(19)30193-6
更新日期:2019-09-01 00:00:00
abstract:BACKGROUND:Although antiretroviral regimens containing integrase inhibitors rapidly suppress HIV viral load in non-pregnant adults, few published data from randomised controlled trials have compared the safety and efficacy of any integrase inhibitor to efavirenz when initiated during pregnancy. We compared safety and e...
journal_title:The lancet. HIV
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/S2352-3018(20)30038-2
更新日期:2020-05-01 00:00:00
abstract:BACKGROUND:HIV evolves rapidly and therefore infections with similar genetic sequences are likely linked by recent transmission events. Clusters of related infections can represent subpopulations with high rates of transmission. We describe the implementation of an automated near real-time system to monitor and charact...
journal_title:The lancet. HIV
pub_type: 杂志文章
doi:10.1016/S2352-3018(16)00046-1
更新日期:2016-05-01 00:00:00
abstract:BACKGROUND:With continued roll-out of antiretroviral therapy (ART) in resource-limited settings, evidence is emerging of increasing levels of transmitted drug-resistant HIV. We aimed to compare the effectiveness and cost-effectiveness of different potential public health responses to substantial levels of transmitted d...
journal_title:The lancet. HIV
pub_type: 杂志文章
doi:10.1016/S2352-3018(14)70021-9
更新日期:2014-11-01 00:00:00
abstract:BACKGROUND:Novel strategies are needed to increase retention in and uptake of prevention of mother-to-child HIV transmission (PMTCT) services in sub-Saharan Africa. We aimed to determine whether small, increasing cash payments, which were conditional on attendance at scheduled clinic visits and receipt of proposed serv...
journal_title:The lancet. HIV
pub_type: 杂志文章,随机对照试验
doi:10.1016/S2352-3018(15)00247-7
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:Immune Reconstitution Inflammatory Syndrome (IRIS) is a common complication of antiretroviral therapy (ART) in HIV-infected patients. IRIS is associated with an increased risk of hospitalization and death. We ascertained whether CCR5 blockade using maraviroc reduces the risk of IRIS. METHODS:The CADIRIS stu...
journal_title:The lancet. HIV
pub_type: 杂志文章
doi:10.1016/S2352-3018(14)70027-X
更新日期:2014-11-01 00:00:00
abstract:BACKGROUND:All recent treatment guidelines recommend integrase strand transfer inhibitors (INSTIs) as components of initial HIV therapy. Bictegravir, a novel, once-daily, unboosted INSTI, showed potent activity in a 10 day monotherapy study and has a high in-vitro resistance barrier. On the basis of these results, we d...
journal_title:The lancet. HIV
pub_type: 杂志文章,随机对照试验
doi:10.1016/S2352-3018(17)30016-4
更新日期:2017-04-01 00:00:00
abstract::In our work as clinicians, researchers, and immigrant rights advocates, we have noted increased anxiety about the possibility of deportation and disruptions in care among immigrants with HIV. Before the 2016 US elections, patients rarely asked about HIV treatment in their home countries. However, since the increase in...
journal_title:The lancet. HIV
pub_type: 杂志文章
doi:10.1016/S2352-3018(18)30074-2
更新日期:2018-10-01 00:00:00
abstract::The evaluation of immune-based approaches to achieve an antiretroviral therapy free remission of HIV infection requires proven efficacy through antiretroviral therapy interruption placebo-controlled trials. This approach is not without risk to participants and innovative trial designs need to be developed that minimis...
journal_title:The lancet. HIV
pub_type: 杂志文章,评审
doi:10.1016/S2352-3018(19)30082-7
更新日期:2019-05-01 00:00:00
abstract:BACKGROUND:Whether or not the association between some antiretrovirals used in HIV infection and chronic kidney disease is cumulative is a controversial topic, especially in patients with initially normal renal function. In this study, we aimed to investigate the association between duration of exposure to antiretrovir...
journal_title:The lancet. HIV
pub_type: 临床试验,杂志文章
doi:10.1016/S2352-3018(15)00211-8
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:As HIV incidence and mortality continue to increase in eastern Europe and central Asia, particularly among people who inject drugs (PWID), it is crucial to effectively scale-up opioid agonist therapy (OAT), such as methadone or buprenorphine maintenance therapy, to optimise HIV outcomes. With low OAT coverag...
journal_title:The lancet. HIV
pub_type: 杂志文章
doi:10.1016/S2352-3018(19)30373-X
更新日期:2020-02-01 00:00:00
abstract:BACKGROUND:Doravirine is a novel non-nucleoside reverse transcriptase inhibitor (NNRTI) with a pharmacokinetic profile supporting once-daily dosing, and potent in-vitro activity against the most common NNRTI-resistant HIV-1 variants. We compared doravirine with ritonavir-boosted darunavir, when both were given with two...
journal_title:The lancet. HIV
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/S2352-3018(18)30021-3
更新日期:2018-05-01 00:00:00
abstract:BACKGROUND:Bictegravir co-formulated with emtricitabine and tenofovir alafenamide as a fixed-dose combination is recommended for treatment of HIV-1-infection and might be better tolerated than other integrase inhibitor-based single-tablet regimens, but long-term outcomes data are not available. We assessed the efficacy...
journal_title:The lancet. HIV
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/S2352-3018(19)30077-3
更新日期:2019-06-01 00:00:00
abstract:BACKGROUND:The HIV epidemic in the population of Nairobi as a whole is in decline, but a concentrated sub-epidemic persists in key populations. We aimed to identify an optimal portfolio of interventions to reduce HIV incidence for a given budget and to identify the circumstances in which pre-exposure prophylaxis (PrEP)...
journal_title:The lancet. HIV
pub_type: 杂志文章
doi:10.1016/S2352-3018(17)30021-8
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:Standard approaches to estimation of losses in the HIV cascade of care are typically cross-sectional and do not include the population stages before linkage to clinical care. We used indiviual-level longitudinal cascade data, transition by transition, including population stages, both to identify the health-...
journal_title:The lancet. HIV
pub_type: 杂志文章
doi:10.1016/S2352-3018(16)30224-7
更新日期:2017-05-01 00:00:00
abstract::South Africa intends to include dolutegravir in its first-line antiretroviral therapy (ART) regimen because of cost savings, the drug's high barrier to resistance, and efficacy. However, recent data from Botswana suggest potential teratogenicity of dolutegravir. WHO recommends that non-pregnant women of childbearing a...
journal_title:The lancet. HIV
pub_type: 杂志文章
doi:10.1016/S2352-3018(18)30249-2
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:An intravaginal ring that releases the tenofovir prodrug, tenofovir disoproxil fumarate, provided 100% protection in macaques against simian HIV and was safe in a 14-day clinical trial in sexually abstinent women. We aimed to assess the safety and pharmacokinetics of this intravaginal ring over 90 days in se...
journal_title:The lancet. HIV
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/S2352-3018(19)30145-6
更新日期:2019-08-01 00:00:00
abstract::Novel diagnostic technologies, including nanotechnology, microfluidics, -omics science, next-generation sequencing, genomics big data, and machine learning, could contribute to meeting the UNAIDS 95-95-95 targets to end the HIV epidemic by 2030. Novel technologies include multiplexed technologies (including biomarker-...
journal_title:The lancet. HIV
pub_type: 杂志文章,评审
doi:10.1016/S2352-3018(20)30190-9
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND:The South African national HIV plan recommends pre-exposure prophylaxis (PrEP) for transgender women, whose HIV prevalence estimates are as high as 25% in sub-Saharan Africa. The aim of this study was to explore PrEP awareness, uptake, and willingness, as well as associated barriers and facilitators, in orde...
journal_title:The lancet. HIV
pub_type: 杂志文章
doi:10.1016/S2352-3018(20)30119-3
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:WHO-recommended second-line antiretroviral therapy (ART) of a pharmacologically enhanced (boosted) protease inhibitor plus nucleoside or nucleotide reverse transcriptase inhibitors (NtRTIs) might be compromised by resistance. Results of the 96 week SECOND-LINE randomised trial showed that NtRTI-sparing ART w...
journal_title:The lancet. HIV
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/S2352-3018(14)00061-7
更新日期:2015-02-01 00:00:00
abstract:BACKGROUND:In patients with HIV, immune reconstitution after antiretroviral therapy (ART) is often incomplete. We assessed the probability of patients reaching a CD4/CD8 ratio of 1 or more after the start of ART and its association with the onset of non-AIDS-defining events and death. METHODS:We did an analysis of the...
journal_title:The lancet. HIV
pub_type: 杂志文章
doi:10.1016/S2352-3018(15)00006-5
更新日期:2015-03-01 00:00:00
abstract:BACKGROUND:BMS-663068 is an oral prodrug of BMS-626529, an attachment inhibitor that binds to HIV-1 gp120, blocking viral attachment to host CD4 cells. AI438011 is an ongoing trial investigating the efficacy, safety, and dose-response of BMS-663068 in treatment-experienced, HIV-1-infected patients. Herein we present th...
journal_title:The lancet. HIV
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/S2352-3018(15)00177-0
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:The number of people on antiretroviral therapy (ART) requiring treatment monitoring in low-resource settings is rapidly increasing. Point-of-care (POC) testing for ART monitoring might alleviate burden on centralised laboratories and improve clinical outcomes, but its cost-effectiveness is unknown. METHODS:...
journal_title:The lancet. HIV
pub_type: 杂志文章
doi:10.1016/S2352-3018(20)30279-4
更新日期:2020-12-18 00:00:00
abstract:BACKGROUND:Tuberculosis, which is often undiagnosed, is the major cause of death among HIV-positive people. We aimed to test whether the use of a clinical algorithm enabling the initiation of empirical tuberculosis treatment by nurses in primary health-care clinics would reduce mortality compared with standard of care ...
journal_title:The lancet. HIV
pub_type: 杂志文章,随机对照试验
doi:10.1016/S2352-3018(19)30266-8
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:As pre-exposure prophylaxis (PrEP) with tenofovir disoproxil fumarate and emtricitabine for the prevention of HIV infection is rolled out internationally, strategies to maintain effectiveness and to minimise adverse effects merit consideration. In this study, we aimed to assess reductions in renal function a...
journal_title:The lancet. HIV
pub_type: 临床试验,杂志文章
doi:10.1016/S2352-3018(16)30153-9
更新日期:2016-11-01 00:00:00
abstract:BACKGROUND:In high HIV burden settings, maximising the coverage of prevention strategies is crucial to achieving epidemic control. However, little is known about the reach and effect of these strategies in some communities. METHODS:We did a cross-sectional community survey in the adjacent Greater Edendale and Vulindle...
journal_title:The lancet. HIV
pub_type: 杂志文章
doi:10.1016/S2352-3018(18)30104-8
更新日期:2018-08-01 00:00:00