Evidence map›Paper›PMID 29223580›Full record

ArticleEpidemics2018

Modeling HIV disease progression and transmission at population-level: The potential impact of modifying disease progression in HIV treatment programs.

Jennifer M Ross, Roger Ying, Connie L Celum, Jared M Baeten, Katherine K Thomas, Pamela M Murnane, Heidi van Rooyen, James P Hughes, Ruanne V Barnabas

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Epidemics, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
0.8field-weighted citation impact, top 27% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 14 citations in OpenAlex.

  1. Article
  2. Article
  3. The healthier healthcare management models for COVID-19.Journal of infection and public health · 2021
    Review
  4. Article
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 5 institutions in 2 countries.

Jennifer M RossDepartment of Medicine, University of Washington, Seattle, WA, USA; Division of Allergy and Infectious Disease, University of Washington, 1959 NE Pacific St., Box 356423, Seattle, WA 98195, USA. Electronic address: jross3@uw.edu.
Roger YingWeill Cornell Medical College, Cornell University, 420 E 70th St., 12J-3, New York, NY 10021, USA. Electronic address: Rying1@gmail.com.
Connie L CelumDepartment of Medicine, University of Washington, Seattle, WA, USA; Department of Global Health, University of Washington, 325 9th Ave., Box 359927, Seattle, WA 98104-2420, USA; Department of Epidemiology, University of Washington, Seattle, WA, USA; Division of Allergy and Infectious Disease, University of Washington, 1959 NE Pacific St., Box 356423, Seattle, WA 98195, USA. Electronic address: ccelum@uw.edu.
Jared M BaetenDepartment of Medicine, University of Washington, Seattle, WA, USA; Department of Global Health, University of Washington, 325 9th Ave., Box 359927, Seattle, WA 98104-2420, USA; Department of Epidemiology, University of Washington, Seattle, WA, USA; Division of Allergy and Infectious Disease, University of Washington, 1959 NE Pacific St., Box 356423, Seattle, WA 98195, USA. Electronic address: jbaeten@uw.edu.
Katherine K ThomasDepartment of Global Health, University of Washington, 325 9th Ave., Box 359927, Seattle, WA 98104-2420, USA. Electronic address: kkthomas@uw.edu.
Pamela M MurnaneDepartment of Global Health, University of Washington, 325 9th Ave., Box 359927, Seattle, WA 98104-2420, USA; Department of Epidemiology, University of Washington, Seattle, WA, USA; Center for AIDS Prevention Studies, Department of Medicine, University of California San Francisco. Electronic address: pmurnane@gmail.com.
Heidi van RooyenHuman Sciences Research Council, Durban, South Africa. Electronic address: hvanrooyen@hsrc.ac.za.
James P HughesDepartment of Biostatistics, University of Washington, 1959 NE Pacific St., Box 357232, Seattle, WA 98195, USA; Vaccine and Infectious Diseases Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA. Electronic address: jphughes@uw.edu.
Ruanne V BarnabasDepartment of Medicine, University of Washington, Seattle, WA, USA; Department of Global Health, University of Washington, 325 9th Ave., Box 359927, Seattle, WA 98104-2420, USA; Department of Epidemiology, University of Washington, Seattle, WA, USA; Vaccine and Infectious Diseases Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA; Division of Allergy and Infectious Disease, University of Washington, 1959 NE Pacific St., Box 356423, Seattle, WA 98195, USA. Electronic address: rbarnaba@uw.edu.
University of Washington · USFred Hutch Cancer Center · USCornell University · USHuman Sciences Research Council · ZASan Francisco AIDS Foundation · US

Funding

University of Washington/Fred Hutch Center for AIDS ResearchP30AI027757 · NIAID · UNIVERSITY OF WASHINGTON · PI Kenneth Sherr · 1988 to 2026
$104.9M
Ujima Mentoring ProgramP30MH062246 · NIMH · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Sheri Ann Lippman · 2001 to 2026
$57.4M
TRAINEESHIPS IN AIDS PREVENTION STUDIEST32MH019105 · NIMH · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Carol Suzanne Camlin, Glenn-Milo Santos · 1989 to 2026
$15.3M
Interventions to decrease HIV infectiousness in UgandaRC4AI092552 · NIAID · UNIVERSITY OF WASHINGTON · PI CELUM, CONNIE L · 2010 to 2013
$5.6M
Multi-component, Targeted HIV Prevention for sub-Saharan Africa: PreventionRxR01AI083034 · NIAID · UNIVERSITY OF WASHINGTON · PI CELUM, CONNIE L · 2009 to 2012
$4.3M
NIAID NIH HHS P30 AI027757NIAID NIH HHS R01 AI083034NIAID NIH HHS RC4 AI092552NIMH NIH HHS P30 MH062246NIMH NIH HHS T32 MH019105
6 · The paper itself

Abstract

introductionMathematical models that incorporate HIV disease progression dynamics can estimate the potential impact of strategies that delay HIV disease progression and reduce infectiousness for persons not on antiretroviral therapy (ART). Suppressive treatment of HIV-positive persons co-infected with herpes simplex virus-2 (HSV-2) with valacyclovir, an HSV-2 antiviral, can lower HIV viral load, but the impact of partially-suppressive valacyclovir relative to fully-suppressive ART on population HIV transmission has not been estimated.

methodsWe modeled HIV disease progression as a function of changes in viral load and CD4 count over time among ART naïve persons. The disease progression Markov model was nested within a dynamic model of HIV transmission at population level. We assumed that valacyclovir reduced HIV viral load by 1.23 log copies/μL, and that persons treated with valacyclovir initiated ART more rapidly when their CD4 fell below 500 due to retention in HIV care. We estimated the potential impact of valacyclovir on onward transmission of HIV in three scenarios of different ART and valacyclovir population coverage.

resultsThe average duration of HIV infection was 9.5 years. The duration of disease before reaching CD4 200cells/μL was 2.53 years longer for females than males. Relative to a baseline of ART initiation at CD4≤500cells/μL, the valacyclovir scenario resulted in 167,000 fewer HIV infections over ten years, with an incremental cost-effectiveness ratio (ICER) of $5276 per HIV infection averted. A Test and Treat scenario with 70% ART coverage and no valacyclovir resulted in 350,000 fewer HIV infections at an ICER of $2822 and $812 per HIV infection averted and QALY gained, respectively.

conclusionEven when compared with valacyclovir suppression, a drug that reduces HIV viral load, universal treatment for HIV is the optimal strategy for averting new infections and increasing public health benefit. Universal HIV treatment would most effectively and efficiently reduce the HIV burden.

Indexed as

AdultAfrica South of the SaharaAntiviral AgentsCost-Benefit AnalysisDisease ProgressionFemaleFollow-Up StudiesHIV InfectionsHumansMaleMarkov ChainsValacyclovirViral LoadAntiviral AgentsValacyclovirARTdisease progressionherpes simplex virusHIVHIV preventionmathematical modelingvalacyclovir

Identifiers

PMID29223580
PMCPMC5975109
OpenAlexW2951535570

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.