ArticleHIV medicine2015
Impact of defined clinical population and missing data on temporal trends in HIV viral load estimation within a health care system.
Article in HIV medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Community viral load and hepatitis C virus infection: Community viral load measures to aid public health treatment efforts and program evaluation.Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology · 2020Pooled it
- Study Protocol(s) for Antiretroviral Improvement among Medicaid EnrolleeS (AIMS): A Cluster-Randomized Controlled Trial Leveraging Real-time Administrative Claims to Support Antiretroviral Prescription Adherence.Contemporary clinical trials · 2025Article
- Violence experience among cis-gender women living with HIV in Atlanta, Georgia: impact on HIV-related health and their preferences for violence screening and support.Frontiers in public health · 2025Article
- Working with HIV clinics to adopt addiction treatment using implementation facilitation (WHAT-IF?): Rationale and design for a hybrid type 3 effectiveness-implementation study.Contemporary clinical trials · 2020Article
- Hepatitis C Virus (HCV) Care Continuum Outcomes and HCV Community Viral Loads Among Patients in an Opioid Treatment Program.The Journal of infectious diseases · 2020Article
- Retention in HIV care during the 3 years following release from incarceration: A cohort study.PLoS medicine · 2018Article
- Continuing Links Between Substance Use and HIV Highlight the Importance of Nursing Roles.The Journal of the Association of Nurses in AIDS Care : JANACArticle
Corrections and comments
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Authors and funding
13 authors.
Funding
Abstract
objectivesCommunity viral load (CVL) estimates vary based on analytic methods. We extended the CVL concept and used data from the Veterans Health Administration (VA) to determine trends in the health care system viral load (HSVL) and its sensitivity to varying definitions of the clinical population and assumptions regarding missing data.
methodsWe included HIV-infected patients in the Veterans Aging Cohort Study, 2000-2010, with at least one documented CD4 count, HIV-1 RNA or antiretroviral prescription (n = 37 318). We created 6-month intervals including patients with at least one visit in the past 2 years. We assessed temporal trends in clinical population size, patient clinical status and mean HSVL and explored the impact of varying definitions of the clinical population and assumptions about missing viral load.
resultsThe clinical population size varied by definition, increasing from 16 000-19 000 patients in 2000 to 23 000-26 000 in 2010. The proportion of patients with suppressed HIV-1 RNA increased over time. Over 20% of patients had no viral load measured in a given interval or the past 2 years. Among patients with a current HIV-1 RNA, mean HSVL decreased from 97 800 HIV-1 RNA copies/mL in 2000 to 2000 copies/mL in 2010. When current HIV-1 RNA data were unavailable and the HSVL was recalculated using the last available HIV-1 RNA, HSVL decreased from 322 300 to 9900 copies/mL. HSVL was underestimated when using only current data in each interval.
conclusionsThe CVL concept can be applied to a health care system, providing a measure of health care quality. Like CVL, HSVL estimates depend on definitions of the clinical population and assumptions about missing data.
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