Trends in Use of Combination Antiretroviral Therapy and Treatment Response from 2000 to 2016 in the Canadian Observational Cohort (CANOC): A Longitudinal Cohort Study.

CD4 count HIV antiretroviral therapy utilization

Journal

The Canadian journal of hospital pharmacy
ISSN: 1920-2903
Titre abrégé: Can J Hosp Pharm
Pays: Canada
ID NLM: 0215645

Informations de publication

Date de publication:
2022
Historique:
entrez: 17 10 2022
pubmed: 18 10 2022
medline: 18 10 2022
Statut: epublish

Résumé

Advances in treatment have turned HIV from a terminal illness to a more manageable condition. Over the past 20 years, there have been considerable changes to HIV treatment guidelines, including changes in preferred antiretrovirals and timing of initiation of combination antiretroviral therapy (cART). To examine real-world trends in cART utilization, viral control, and immune reconstitution among people living with HIV in Canada. Data were obtained from the Canadian Observational Cohort (CANOC). CANOC participants were eligible if they were antiretroviral therapy-naive at entry and initiated 3 or more antiretrovirals on or after January 1, 2000; if they were at least 18 years of age at treatment initiation; if they were residing in Canada; and if they had at least 1 viral load determination and CD4 count within 1 year of CANOC entry. Baseline and annual mean CD4 counts were categorized as less than 200, 200-350, 351-500, and more than 500 cells/mm All CANOC participants were included ( Concordance with treatment guidelines was demonstrated over time with respect to cART prescribing and immunologic and virologic response. Les progrès effectués dans le domaine des traitements ont transformé le VIH. Celui-ci est passé d’une maladie en phase terminale à une maladie plus gérable. Au cours des 20 dernières années, des changements considérables ont eu lieu dans les directives de traitement du VIH, y compris des changements dans les antirétroviraux privilégiés et le moment de l’initiation de la thérapie antirétrovirale combinée (TARc). Examiner les tendances réelles de l’utilisation de la TARc, du contrôle viral et de la reconstitution immunitaire chez les personnes vivant avec le VIH au Canada. Les données ont été obtenues auprès de la Canadian Observational Cohort (CANOC). Les participants à la CANOC étaient admissibles s’ils n’avaient jamais reçu de traitement antirétroviral à l’entrée et avaient commencé la prise de 3 antirétroviraux ou plus le 1 Tous les participants à la CANOC ont été inclus ( La concordance avec les directives de traitement a été démontrée au fil du temps en ce qui concerne la prescription de la cART et la réponse immunologique et virologique.

Sections du résumé

Background UNASSIGNED
Advances in treatment have turned HIV from a terminal illness to a more manageable condition. Over the past 20 years, there have been considerable changes to HIV treatment guidelines, including changes in preferred antiretrovirals and timing of initiation of combination antiretroviral therapy (cART).
Objective UNASSIGNED
To examine real-world trends in cART utilization, viral control, and immune reconstitution among people living with HIV in Canada.
Methods UNASSIGNED
Data were obtained from the Canadian Observational Cohort (CANOC). CANOC participants were eligible if they were antiretroviral therapy-naive at entry and initiated 3 or more antiretrovirals on or after January 1, 2000; if they were at least 18 years of age at treatment initiation; if they were residing in Canada; and if they had at least 1 viral load determination and CD4 count within 1 year of CANOC entry. Baseline and annual mean CD4 counts were categorized as less than 200, 200-350, 351-500, and more than 500 cells/mm
Results UNASSIGNED
All CANOC participants were included (
Conclusions UNASSIGNED
Concordance with treatment guidelines was demonstrated over time with respect to cART prescribing and immunologic and virologic response.
Contexte UNASSIGNED
Les progrès effectués dans le domaine des traitements ont transformé le VIH. Celui-ci est passé d’une maladie en phase terminale à une maladie plus gérable. Au cours des 20 dernières années, des changements considérables ont eu lieu dans les directives de traitement du VIH, y compris des changements dans les antirétroviraux privilégiés et le moment de l’initiation de la thérapie antirétrovirale combinée (TARc).
Objectif UNASSIGNED
Examiner les tendances réelles de l’utilisation de la TARc, du contrôle viral et de la reconstitution immunitaire chez les personnes vivant avec le VIH au Canada.
Méthodes UNASSIGNED
Les données ont été obtenues auprès de la Canadian Observational Cohort (CANOC). Les participants à la CANOC étaient admissibles s’ils n’avaient jamais reçu de traitement antirétroviral à l’entrée et avaient commencé la prise de 3 antirétroviraux ou plus le 1
Résultats UNASSIGNED
Tous les participants à la CANOC ont été inclus (
Conclusions UNASSIGNED
La concordance avec les directives de traitement a été démontrée au fil du temps en ce qui concerne la prescription de la cART et la réponse immunologique et virologique.

Autres résumés

Type: Publisher (fre)
Les progrès effectués dans le domaine des traitements ont transformé le VIH. Celui-ci est passé d’une maladie en phase terminale à une maladie plus gérable. Au cours des 20 dernières années, des changements considérables ont eu lieu dans les directives de traitement du VIH, y compris des changements dans les antirétroviraux privilégiés et le moment de l’initiation de la thérapie antirétrovirale combinée (TARc).

Identifiants

DOI: 10.4212/cjhp.3234 PMID: 36246433 PMC: PMC9524546
pubmed: 36246433
doi: 10.4212/cjhp.3234
pii: cjhp-75-309
pmc: PMC9524546
doi:

Types de publication

Journal Article

Langues

eng

Pagination

309-316

Informations de copyright

2022 Canadian Society of Hospital Pharmacists. All content in the Canadian Journal of Hospital Pharmacy is copyrighted by the Canadian Society of Hospital Pharmacy. In submitting their manuscripts, the authors transfer, assign, and otherwise convey all copyright ownership to CSHP.

Déclaration de conflit d'intérêts

Competing interests: For activities not related to the study reported here, Mona Loutfy has received research grants from AbbVie, Gilead, and ViiV Healthcare; Curtis Cooper has received unrestricted program support from Gilead and AbbVie, and has served on advisory boards for Gilead, AbbVie, and ViiV Healthcare; Réjean Thomas has received research grants from and has served on advisory boards for Gilead, Merck, and ViiV Healthcare, and has participated as an investigator in clinical trials for AbbVie, Gilead, GSK/ViiV Healthcare, Janssen, and Merck; Marina Klein has received grants for investigator-initiated studies from Gilead, Merck, ViiV Healthcare, and AbbVie, has received research grants from Janssen, and has received personal fees from Gilead, Merck, ViiV Healthcare, and AbbVie; and Julio Montaner has received institutional support from the BC Ministry of Health and the Public Health Agency of Canada, as well as institutional grants from Gilead, Merck, and ViiV Healthcare. No other competing interests were declared.

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Auteurs

Alison R McClean (AR)

, PharmD, is with the British Columbia Centre for Excellence in HIV/AIDS and The University of British Columbia, Vancouver, British Columbia.

Jason Trigg (J)

, MA, is with the British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia.

Claudette Cardinal (C)

is with the British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia.

Mona Loutfy (M)

, MD, MPH, is with the Maple Leaf Medical Clinic, the Women's College Research Institute, and the University of Toronto, Toronto, Ontario.

Curtis Cooper (C)

, MD, MSc, is with the Ottawa Hospital Research Institute and the University of Ottawa, Ottawa, Ontario.

Abigail Kroch (A)

, MPH, PhD, is with the University of Toronto, Toronto, Ontario.

Mostafa Shokoohi (M)

, PhD, is with the University of Toronto, Toronto, Ontario.

Nimâ Machouf (N)

, PhD, is with the Clinique de Médecine Urbaine du Quartier Latin, Montréal, Quebec.

Réjean Thomas (R)

, MD, was, at the time this study was performed, with the Clinique de Médecine Urbaine du Quartier Latin, Montréal, Quebec. He is now with the Clinique médicale l'Actuel, Montréal, Quebec.

Marina B Klein (MB)

, MD, MSc, is with the McGill University Health Centre, Montréal, Quebec.

Deborah V Kelly (DV)

, PharmD, is with Memorial University of Newfoundland, St John's, Newfoundland and Labrador.

Alexander Wong (A)

, MD, is with the University of Saskatchewan, Regina, Saskatchewan.

Stephen Sanche (S)

, MD, is with the University of Saskatchewan, Regina, Saskatchewan.

Julio S G Montaner (JSG)

, MD, is with the British Columbia Centre for Excellence in HIV/AIDS and The University of British Columbia, Vancouver, British Columbia.

Robert S Hogg (RS)

, PhD, is with the British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, and Simon Fraser University, Burnaby, British Columbia.

Classifications MeSH