Observational studyHIV medicine2015
Predictors of unstructured antiretroviral treatment interruption and resumption among HIV-positive individuals in Canada.
Observational study in HIV medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Factors related to loss to follow-up among people living with HIV: a systematic review.Revista do Instituto de Medicina Tropical de Sao Paulo · 2025Pooled it
- Population mobility and disease progression in people living with HIV: a machine learning analysis of a 10-year dynamic cohort.Frontiers in public health · 2026Article
- Factors associated with loss to follow-up among people living with HIV at public health facilities in Manaus, Brazil: a multicentric study.BMC public health · 2025Article
- Article
- It's all about connection: Determinants of social support and the influence on HIV treatment interruptions among people living with HIV in British Columbia, Canada.BMC public health · 2023Article
- Antiretroviral treatment interruption and resumption within 16 weeks among HIV-positive adults in Jinan, China: a retrospective cohort study.Frontiers in public health · 2023Article
- Predictors of antiretroviral therapy interruptions and factors influencing return to care at the Nkolndongo Health District, Cameroon.African health sciences · 2021Article
- Economic, Mental Health, HIV Prevention and HIV Treatment Impacts of COVID-19 and the COVID-19 Response on a Global Sample of Cisgender Gay Men and Other Men Who Have Sex with Men.AIDS and behavior · 2021Article
- Examining Correlates of Pre-ART and Early ART Adherence to Identify Key Factors Influencing Adherence Readiness.AIDS and behavior · 2021Article
- Article
- Factors Associated With Antiretroviral Therapy Reinitiation in Medicaid Recipients With Human Immunodeficiency Virus.The Journal of infectious diseases · 2020Article
- Risk factors for antiretroviral therapy (ART) discontinuation in a large multinational trial of early ART initiators.AIDS (London, England) · 2019Article
- Characterizing Human Immunodeficiency Virus Antiretroviral Therapy Interruption and Resulting Disease Progression Using Population-Level Data in British Columbia, 1996-2015.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2017Article
- Antiretroviral Therapy Interruption Among HIV Postive People Who Use Drugs in a Setting with a Community-Wide HIV Treatment-as-Prevention Initiative.AIDS and behavior · 2017Article
- Predictors of viral suppression and rebound among HIV-positive men who have sex with men in a large multi-site Canadian cohort.BMC infectious diseases · 2016Observational
- Discontinuation of Initial Antiretroviral Therapy in Clinical Practice: Moving Toward Individualized Therapy.Journal of acquired immune deficiency syndromes (1999) · 2016Article
- Risk factors for unstructured treatment interruptions and association with survival in low to middle income countries.AIDS research and therapy · 2016Article
- The impact of criminalization of HIV non-disclosure on the healthcare engagement of women living with HIV in Canada: a comprehensive review of the evidence.Journal of the International AIDS Society · 2015Review
Corrections and comments
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Authors and funding
14 authors.
Funding
Abstract
objectivesSustained optimal use of combination antiretroviral therapy (cART) has been shown to decrease morbidity, mortality and HIV transmission. However, incomplete adherence and treatment interruption (TI) remain challenges to the full realization of the promise of cART. We estimated trends and predictors of treatment interruption and resumption among individuals in the Canadian Observational Cohort (CANOC) collaboration.
methodscART-naïve individuals ≥ 18 years of age who initiated cART between 2000 and 2011 were included in the study. We defined TIs as ≥ 90 consecutive days off cART. We used descriptive analyses to study TI trends over time and Cox regression to identify factors predicting time to first TI and time to treatment resumption after a first TI.
resultsA total of 7633 participants were eligible for inclusion in the study, of whom 1860 (24.5%) experienced a TI. The prevalence of TI in the first calendar year of cART decreased by half over the study period. Our analyses highlighted a higher risk of TI among women [adjusted hazard ratio (aHR) 1.59; 95% confidence interval (CI) 1.33-1.92], younger individuals (aHR 1.27; 95% CI 1.15-1.37 per decade increase), earlier treatment initiators (CD4 count ≥ 350 vs. <200 cells/μL: aHR 1.46; 95% CI 1.17-1.81), Aboriginal participants (aHR 1.67; 95% CI 1.27-2.20), injecting drug users (aHR 1.43; 95% CI 1.09-1.89) and users of zidovudine vs. tenofovir in the initial cART regimen (aHR 2.47; 95% CI 1.92-3.20). Conversely, factors predicting treatment resumption were male sex, older age, and a CD4 cell count <200 cells/μL at cART initiation.
conclusionsDespite significant improvements in cART since its advent, our results demonstrate that TIs remain relatively prevalent. Strategies to support continuous HIV treatment are needed to maximize the benefits of cART.
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