ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2017
Characterizing Human Immunodeficiency Virus Antiretroviral Therapy Interruption and Resulting Disease Progression Using Population-Level Data in British Columbia, 1996-2015.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Real-World Persistence in Adults with HIV and Mental Health or Substance Use Disorders After Restarting Antiretroviral Therapy in the United States.Advances in therapy · 2025Observational
- Depressive Symptoms, the Impact on ART Continuation, and Factors Associated with Symptom Improvement Among a Cohort of People Living with HIV in British Columbia, Canada.AIDS and behavior · 2024Article
- Translating and disseminating a localised economic model to support implementation of the 'Ending the HIV Epidemic' initiative to public health policymakers.Evidence & policy : a journal of research, debate and practice · 2023Article
- A case report of clinical implications of a delayed antiretroviral therapy switch in a patient with multiple treatment interruptions.SAGE open medical case reports · 2022Article
- A co-interaction model of HIV and syphilis infection among gay, bisexual and other men who have sex with men.Infectious Disease Modelling · 2020Article
- Combined estimation of disease progression and retention on antiretroviral therapy among treated individuals with HIV in the USA: a modelling study.The lancet. HIV · 2019Article
- Antisense RNA: the new favorite in genetic research.Journal of Zhejiang University. Science. BReview
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7 authors.
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Abstract
backgroundSuboptimal retention is among the biggest challenges to realize the full benefits of combination antiretroviral therapy (ART). We aimed to describe ART interruption patterns and identify determinants of disease progression while off ART in British Columbia, Canada.
methodsWith population-level data on ART utilization and laboratory testing in British Columbia (1996-2015), we described the timing, frequency, and duration of ART interruptions (a gap of ≥90 days in ART dispensation records). A 4-state continuous-time Markov model was implemented to identify determinants of disease progression during individuals' first ART interruption episode. Disease progression was measured according to CD4-based state transitions (cells/μL: ≥500 to 200-499; 200-499 to <200; ≥500 to death; 200-499 to death; and <200 to death).
resultsAmong individuals initiating ART, 3129 (38.6%) interrupted ART over a median 8-year follow-up (interquartile range [IQR], 4.3-13.5 years). Those interrupting ART had a median of 1 interruption (IQR, 1.0-3.0), with the first interruption occurring 12.8 (IQR, 4.0-36.1) months after ART initiation, lasting for 7.5 (IQR, 4.1-20.3) months. The proportion of individuals interrupting ART within the first year of ART initiation decreased over time; however, the absolute number of individuals interrupting ART remained high. In a multivariable analysis, age, historical plasma viral load, and ART regimen changes prior to interruption were associated with increased hazard of CD4 decline and death.
conclusionsOur results demonstrate that ART interruptions are common even in a high-resource setting with universal free access to human immunodeficiency virus care. Further efforts are needed to promote ART reengagement and may consider prioritizing individuals with poorer prognostic factors.
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