Trends in antiretroviral treatment use and treatment response in three Australian states in the first decade of combination antiretroviral treatment
Trends in antiretroviral treatment use and treatment response in three Australian states in the first decade of combination antiretroviral treatment
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DOI：
10.1071/sh07082
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发表时间：
2008-01-01
期刊：
影响因子：
1.6
通讯作者：
Law, Matthew
中科院分区：
文献类型：
--
作者：
Falster, Kathleen;Gelgor, Linda;Law, Matthew
目的：确定1997年至2006年期间，澳大利亚东部三个州（新南威尔士州、维多利亚州和昆士兰州）抗逆转录病毒治疗（ART）的使用是否存在任何差异。方法：我们使用来自澳大利亚艾滋病观察数据库（AHOD）的临床队列数据，以确定每个州选定诊所中接受ART的艾滋病感染患者的比例以及病毒载量检测不到的治疗患者的比例。来自国家高度专业化药物计划和AHOD的数据被用来估计全国和各州接受抗逆转录病毒治疗的总人数和艾滋病毒感染者接受抗逆转录病毒治疗的比例。来自艾滋病毒未来调查和同性恋社区定期调查的数据用于确定接受抗逆转录病毒治疗的社区男男性行为者的比例。诊断后1年内开始抗逆转录病毒治疗的原发性艾滋病毒感染（PHI）患者的比例来自急性感染和早期疾病研究计划（AIEDRP）CORE 01方案和原发性艾滋病毒和早期疾病研究：澳大利亚队列（PHAESTRA）队列。结果如下：我们估计，在2000年至2006年期间，新南威尔士州接受抗逆转录病毒治疗的人数从3181人增加到4553人，维多利亚州从1309人增加到1926人，昆士兰州从809人增加到1615人。然而，这些数字可能反映了新南威尔士州接受抗逆转录病毒疗法的艾滋病毒感染者比例低于其他州（37%，2000年为49%和55%）。我们发现，在研究期间，在所有三个州，基于诊所的AHOD队列（81-92%）和澳大利亚的两项大型社区调查（69-85%和49-83%）中，与男性发生性关系的HIV阳性男性参与者接受ART的比例相似。在这三个州，接受治疗的患者中病毒载量检测不到的比例相似，在所有州都观察到随着时间的推移呈持续增加的趋势。我们发现，更多的PHI患者开始治疗后的第一年艾滋病毒诊断在新南威尔士州相比，维多利亚，但是，样本量非常小。结论：在大多数情况下，使用来自澳大利亚队列研究、社区调查和国家处方数据库的一系列可用数据，新南威尔士州、维多利亚州和昆士兰州的抗逆转录病毒药物使用模式相似。然而，与其他州相比，新南威尔士州接受抗逆转录病毒治疗的艾滋病毒感染者比例可能较低，而且有迹象表明，与维多利亚州相比，新南威尔士州的PHI患者治疗方法更具侵略性。
Objectives: To determine if there were any differences in antiretroviral treatment (ART) use across the three eastern states of Australia, New South Wales (NSW), Victoria and Queensland, during the period 1997 to 2006. Methods: We used data from a clinic-based cohort, the Australian HIV Observational Database (AHOD), to determine the proportion of HIV-infected patients on ART in selected clinics in each state and the proportion of treated patients with an undetectable viral load. Data from the national Highly Specialised Drugs program and AHOD were used to estimate total numbers of individuals on ART and the proportion of individuals living with HIV on ART nationally and by state. Data from the HIV Futures Survey and the Gay Community Periodic Survey were used to determine the proportion of community-based men who have sex with men on ART. The proportion of patients with primary HIV infection (PHI) who commenced ART within 1 year of diagnosis was obtained from the Acute Infection and Early Disease Research Program (AIEDRP) CORE01 protocol and Primary HIV and Early Disease Research: Australian Cohort (PHAEDRA) cohorts. Results: We estimated that the numbers of individuals on ART increased from 3181 to 4553 in NSW, 1309 to 1926 in Victoria and 809 to 1615 in Queensland between 2000 and 2006. However, these numbers may reflect a lower proportion of individuals living with HIV on ART in NSW compared with the other states (37% compared with 49 and 55% in 2000). We found similar proportions of HIV-positive men who have sex with men participants were on ART in all three states over the study period in the clinic-based AHOD cohort (81-92%) and two large, community-based surveys in Australia (69-85% and 49-83%). Similar proportions of treated patients had an undetectable viral load across the three states, with a consistently increasing trend over time observed in all states. We found that more PHI patients commenced treatment in the first year following HIV diagnosis in NSW compared with Victoria; however, the sample size was very small. Conclusions: For the most part, patterns of ART use were similar across NSW, Victoria and Queensland using a range of available data from cohort studies, community surveys and national prescription databases in Australia. However, there may be a lower proportion of individuals living with HIV on ART in NSW compared with the other states, and there is some indication of a more aggressive treatment approach with PHI patients in NSW compared with Victoria.