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Receipt of treatment increased among adults with HIV in US
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The number of HIV-infected adults in the United States receiving highly active antiretroviral therapy increased between 2000 and 2008, according to findings published in the Annals of Internal Medicine.
Researchers also observed an increase in the percentage of patients with suppressed HIV plasma viral loads and CD4 cell counts at death.
“In the 30 years since the HIV epidemic was recognized in the United States, remarkable advances in treatment have turned a rapidly fatal disease into a chronic illness for persons who are aware of their infection and can access effective care,” the researchers wrote.
Keri N. Althoff, PhD, MPH, assistant professor in the department of epidemiology at Johns Hopkins Bloomberg School of Public Health, and colleagues examined a nationally representative sample of 45,529 HIV-infected patients who received care from 2000 to 2008 at outpatient clinics enrolled in the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) — the largest cohort of HIV-infected adults in North America. Patients’ treatment characteristics, including viral load, CD4 counts and whether they received HAART were assessed.
Althoff and colleagues also tested the reliability of the NA-ACCORD to monitor HIV epidemic trends in the United States by comparing the cohort’s demographic data with data reported to the CDC.
During the study period, the number of patients prescribed HAART increased from 74% to 83% (P<.001). The proportion of patients with suppressed HIV viral loads increased from 46% to 72% (P<.001), and the median CD4 cell count at death more than tripled from 2000 to 2008 (P<.001). Althoff and colleagues found that the NA-ACCROD cohort had qualitatively similar demographic characteristics to the CDC’s HIV/AIDS Reporting System.
“This is good news for the HIV epidemic in the US, but there is room for improvement,” Althoff said in a press release. “We need to continue to focus on linking HIV-infected adults into care and effective treatment, not only for the individual’s health, but to reduce the likelihood of transmission to others.”
Disclosure: The researchers were supported by grants from the NIH, the Canadian Institutes of Health Research, the Canadian HIV Trials Network, the government of British Columbia and the US CDC. See the study for the full list of financial disclosures.
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