U.S. trends in antiretroviral therapy use, HIV RNA plasma viral loads, and CD4 T-lymphocyte cell counts among HIV-infected persons, 2000 to 2008.

U.S. trends in antiretroviral therapy use, HIV RNA plasma viral loads, and CD4 T-lymphocyte cell counts among HIV-infected persons, 2000 to 2008.
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DOI:
10.7326/0003-4819-157-5-201209040-00005
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发表时间:
2012-09-04
影响因子:
39.2
通讯作者:
North American AIDS Cohort Collaboration on Research and Design
North American AIDS Cohort Collaboration on Research and Design
中科院分区:
医学1区
文献类型:
--
作者:
Althoff KN;Buchacz K;Hall HI;Zhang J;Hanna DB;Rebeiro P;Gange SJ;Moore RD;Kitahata MM;Gebo KA;Martin J;Justice AC;Horberg MA;Hogg RS;Sterling TR;Cescon A;Klein MB;Thorne JE;Crane HM;Mugavero MJ;Napravnik S;Kirk GD;Jacobson LP;Brooks JT;North American AIDS Cohort Collaboration on Research and Design

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2015 年美国国家艾滋病毒/艾滋病战略目标包括增加美国艾滋病毒感染者 (PLWH-US) 获得护理的机会并改善其健康状况。展示 NA-ACCORD(北美艾滋病队列研究与设计合作组织)在监测美国艾滋病毒流行趋势方面的实用性,并展示艾滋病毒治疗和相关健康结果的趋势。年度横断面分析的趋势,将来自汇总、多中心、前瞻性临床 HIV 队列研究的患者与美国 PLWH 患者进行比较,并向 40 个州的国家监测系统报告。美国艾滋病毒门诊。 2000 年 1 月 1 日至 2008 年 12 月 31 日期间任何日历年中测量到的 HIV RNA 血浆病毒载量 (HIV VL) 或 CD4 T 淋巴细胞 (CD4) 细胞计数为 1 或以上的 HIV 感染成人。抗逆转录病毒治疗的年使用率、HIV VL 和死亡时 CD4 细胞计数。 2000 年至 2008 年,45 529 名 HIV 感染者在参与 NA-ACCORD 的美国临床队列中接受护理。2008 年,26 030 名 NA-ACCORD 护理参与者和 655 966 名 PLWH-US 具有相似的人口统计特征。从 2000 年到 2008 年,接受高效抗逆转录病毒治疗的参与者比例增加了 9 个百分点,达到 83%(P < 0.001),而 HIV VL 受到抑制(≤2.7 log10 拷贝/mL)的参与者比例增加了 26 个百分点,达到 72%(P < 0.001)。死亡时 CD4 细胞计数中位数增加了两倍多,达到 0.209 × 109 个细胞/L (P < 0.001)。观察数据的通常局限性适用。 NA-ACCORD 是美国临床护理中最大的 HIV 感染成年人队列,其人口统计学与 2008 年的 PLWH-US 相似。从 2000 年到 2008 年,观察到处方 HAART 的百分比、实现 HIV VL 抑制的百分比以及死亡时 CD4 细胞计数中位数有所增加。美国国立卫生研究院、疾病控制与预防中心、加拿大卫生研究院、加拿大艾滋病毒试验网络以及加拿大不列颠哥伦比亚省政府。
The U.S. National HIV/AIDS Strategy targets for 2015 include increasing access to care and improving health outcomes for persons living with HIV in the United States (PLWH-US). To demonstrate the utility of the NA-ACCORD (North American AIDS Cohort Collaboration on Research and Design) for monitoring trends in the HIV epidemic in the United States and to present trends in HIV treatment and related health outcomes. Trends from annual cross-sectional analyses comparing patients from pooled, multicenter, prospective, clinical HIV cohort studies with PLWH-US, as reported to national surveillance systems in 40 states. U.S. HIV outpatient clinics. HIV-infected adults with 1 or more HIV RNA plasma viral load (HIV VL) or CD4 T-lymphocyte (CD4) cell count measured in any calendar year from 1 January 2000 to 31 December 2008. Annual rates of antiretroviral therapy use, HIV VL, and CD4 cell count at death. 45 529 HIV-infected persons received care in an NA-ACCORD–participating U.S. clinical cohort from 2000 to 2008. In 2008, the 26 030 NA-ACCORD participants in care and the 655 966 PLWH-US had qualitatively similar demographic characteristics. From 2000 to 2008, the proportion of participants prescribed highly active antiretroviral therapy increased by 9 percentage points to 83% (P < 0.001), whereas the proportion with suppressed HIV VL (≤2.7 log10 copies/mL) increased by 26 percentage points to 72% (P < 0.001). Median CD4 cell count at death more than tripled to 0.209 × 109 cells/L (P < 0.001). The usual limitations of observational data apply. The NA-ACCORD is the largest cohort of HIV-infected adults in clinical care in the United States that is demographically similar to PLWH-US in 2008. From 2000 to 2008, increases were observed in the percentage of prescribed HAART, the percentage who achieved a suppressed HIV VL, and the median CD4 cell count at death. National Institutes of Health, Centers for Disease Control and Prevention, Canadian Institutes of Health Research, Canadian HIV Trials Network, and the government of British Columbia, Canada.
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