HIV care visits and time to viral suppression, 19 U.S. jurisdictions, and implications for treatment, prevention and the national HIV/AIDS strategy.
HIV care visits and time to viral suppression, 19 U.S. jurisdictions, and implications for treatment, prevention and the national HIV/AIDS strategy.
复制标题
DOI：
10.1371/journal.pone.0084318
复制
发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Mugavero MJ
中科院分区：
文献类型：
--
作者：
Hall HI;Tang T;Westfall AO;Mugavero MJ
早期和定期护理和治疗人体免疫缺陷病毒（艾滋病毒）感染与抑制病毒、减少传播风险和改善艾滋病毒感染者的健康结果有关。我们确定，在人口水平上，从艾滋病毒诊断到病毒抑制的时间与护理访问的关联。使用来自19个向国家艾滋病毒监测报告艾滋病毒相关检测的地区的数据，我们确定了2009年期间17，028名艾滋病毒诊断者从诊断到病毒抑制的时间，随后使用2012年12月报告的数据，直到2011年12月。使用考克斯比例风险模型，我们评估了与病毒抑制相关的因素，包括诊断后3个月内与护理的联系，国家艾滋病毒/艾滋病战略提出的目标，以及由CD 4和病毒载量检测结果确定的艾滋病毒护理就诊次数，同时控制人口统计学，临床和风险特征。2009年，在19个地区的17 028名艾滋病毒确诊者中，76.6%在确诊后3个月内接受了护理，57.0%在观察期内病毒载量得到抑制。从诊断到病毒抑制的中位时间总体为19个月，初始CD 4计数≤350个细胞/微升的患者为8个月。在诊断后的前12个月内，在3个月内与护理相关的人经历了更短的病毒抑制时间（每单位时间的病毒抑制率更高，风险比[HR]= 4.84 vs 3个月内未联系; 95%置信区间[CI] 4.27，5.48）。 更新时间护理访视次数越多的患者，至病毒抑制的时间也越短（每次额外访视的HR=1.51，95% CI 1.49，1.52）。 及时联系到护理和更频繁的护理访问与更快的病毒抑制时间相关，对个人健康结果和二级预防有影响。
Early and regular care and treatment for human immunodeficiency virus (HIV) infection are associated with viral suppression, reductions in transmission risk and improved health outcomes for persons with HIV. We determined, on a population level, the association of care visits with time from HIV diagnosis to viral suppression. Using data from 19 areas reporting HIV-related tests to national HIV surveillance, we determined time from diagnosis to viral suppression among 17,028 persons diagnosed with HIV during 2009, followed through December 2011, using data reported through December 2012. Using Cox proportional hazards models, we assessed factors associated with viral suppression, including linkage to care within 3 months of diagnosis, a goal set forth by the National HIV/AIDS Strategy, and number of HIV care visits as determined by CD4 and viral load test results, while controlling for demographic, clinical, and risk characteristics. Of 17,028 persons diagnosed with HIV during 2009 in the 19 areas, 76.6% were linked to care within 3 months of diagnosis and 57.0% had a suppressed viral load during the observation period. Median time from diagnosis to viral suppression was 19 months overall, and 8 months among persons with an initial CD4 count ≤350 cells/µL. During the first 12 months after diagnosis, persons linked to care within 3 months experienced shorter times to viral suppression (higher rate of viral suppression per unit time, hazard ratio [HR] = 4.84 versus not linked within 3 months; 95% confidence interval [CI] 4.27, 5.48). Persons with a higher number of time-updated care visits also experienced a shorter time to viral suppression (HR = 1.51 per additional visit, 95% CI 1.49, 1.52). Timely linkage to care and greater frequency of care visits were associated with faster time to viral suppression with implications for individual health outcomes and for secondary prevention.
登录
查看更多内容
影响因子：
11.8
作者：
Horstmann, Elizabeth;Brown, Jillian;Agins, Bruce D.
通讯作者：
Agins, Bruce D.
影响因子：
12.7
作者：
Gray, Kristen Mahle;Tang, Tian;Hall, H. Irene
通讯作者：
Hall, H. Irene
DOI：
10.1086/595705
发表时间：
2009-01-15
期刊：
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
影响因子：
--
作者：
Mugavero MJ;Lin HY;Willig JH;Westfall AO;Ulett KB;Routman JS;Abroms S;Raper JL;Saag MS;Allison JJ
通讯作者：
Allison JJ
影响因子：
3.8
作者：
Marks, Gary;Gardner, Lytt I.;Crepaz, Nicole
通讯作者：
Crepaz, Nicole
影响因子：
39
作者：
Hall, H. Irene;Frazier, Emma L.;Skarbinski, Jacek
通讯作者：
Skarbinski, Jacek