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Viral suppression and viral rebound among young adults living with HIV in Canada

Describe the prevalence and covariates of viral suppression and subsequent rebound among younger (≤29 years old) compared with older adults. A retrospective clinical cohort study; eligibility criteria: documented HIV infection; resident of Canada; 18 years and over; first antiretroviral regimen comp...

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Autores principales: Palmer, Alexis, Gabler, Karyn, Rachlis, Beth, Ding, Erin, Chia, Jason, Bacani, Nic, Bayoumi, Ahmed M., Closson, Kalysha, Klein, Marina, Cooper, Curtis, Burchell, Ann, Walmsley, Sharon, Kaida, Angela, Hogg, Robert
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6392935/
https://www.ncbi.nlm.nih.gov/pubmed/29851775
http://dx.doi.org/10.1097/MD.0000000000010562
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author Palmer, Alexis
Gabler, Karyn
Rachlis, Beth
Ding, Erin
Chia, Jason
Bacani, Nic
Bayoumi, Ahmed M.
Closson, Kalysha
Klein, Marina
Cooper, Curtis
Burchell, Ann
Walmsley, Sharon
Kaida, Angela
Hogg, Robert
author_facet Palmer, Alexis
Gabler, Karyn
Rachlis, Beth
Ding, Erin
Chia, Jason
Bacani, Nic
Bayoumi, Ahmed M.
Closson, Kalysha
Klein, Marina
Cooper, Curtis
Burchell, Ann
Walmsley, Sharon
Kaida, Angela
Hogg, Robert
author_sort Palmer, Alexis
collection PubMed
description Describe the prevalence and covariates of viral suppression and subsequent rebound among younger (≤29 years old) compared with older adults. A retrospective clinical cohort study; eligibility criteria: documented HIV infection; resident of Canada; 18 years and over; first antiretroviral regimen comprised of at least 3 individual agents on or after January 1, 2000. Viral suppression and rebound were defined by at least 2 consecutive viral load measurements <50 or >50 HIV-1 RNA copies/mL, respectively, at least 30 days apart, in a 1-year period. Time to suppression and rebound were measured using the Kaplan–Meier method and Life Table estimates. Accelerated failure time models were used to determine factors independently associated with suppression and rebound. Younger adults experienced lower prevalence of viral suppression and shorter time to viral rebound compared with older adults. For younger adults, viral suppression was associated with being male and later era of combination antiretroviral initiation (cART) initiation. Viral rebound was associated with a history of injection drug use, Indigenous ancestry, baseline CD4 cell count >200, and initiating cART with a protease inhibitor (PI) containing regimen. The influence of age on viral suppression and rebound was modest for this cohort. Our analysis revealed that key covariates of viral suppression and rebound for young adults in Canada are similar to those of known importance to older adults. Women, people who use injection drugs, and people with Indigenous ancestry could be targeted by future health interventions.
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spelling pubmed-63929352019-03-15 Viral suppression and viral rebound among young adults living with HIV in Canada Palmer, Alexis Gabler, Karyn Rachlis, Beth Ding, Erin Chia, Jason Bacani, Nic Bayoumi, Ahmed M. Closson, Kalysha Klein, Marina Cooper, Curtis Burchell, Ann Walmsley, Sharon Kaida, Angela Hogg, Robert Medicine (Baltimore) Research Article Describe the prevalence and covariates of viral suppression and subsequent rebound among younger (≤29 years old) compared with older adults. A retrospective clinical cohort study; eligibility criteria: documented HIV infection; resident of Canada; 18 years and over; first antiretroviral regimen comprised of at least 3 individual agents on or after January 1, 2000. Viral suppression and rebound were defined by at least 2 consecutive viral load measurements <50 or >50 HIV-1 RNA copies/mL, respectively, at least 30 days apart, in a 1-year period. Time to suppression and rebound were measured using the Kaplan–Meier method and Life Table estimates. Accelerated failure time models were used to determine factors independently associated with suppression and rebound. Younger adults experienced lower prevalence of viral suppression and shorter time to viral rebound compared with older adults. For younger adults, viral suppression was associated with being male and later era of combination antiretroviral initiation (cART) initiation. Viral rebound was associated with a history of injection drug use, Indigenous ancestry, baseline CD4 cell count >200, and initiating cART with a protease inhibitor (PI) containing regimen. The influence of age on viral suppression and rebound was modest for this cohort. Our analysis revealed that key covariates of viral suppression and rebound for young adults in Canada are similar to those of known importance to older adults. Women, people who use injection drugs, and people with Indigenous ancestry could be targeted by future health interventions. Wolters Kluwer Health 2018-06-01 /pmc/articles/PMC6392935/ /pubmed/29851775 http://dx.doi.org/10.1097/MD.0000000000010562 Text en Copyright © 2018 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0
spellingShingle Research Article
Palmer, Alexis
Gabler, Karyn
Rachlis, Beth
Ding, Erin
Chia, Jason
Bacani, Nic
Bayoumi, Ahmed M.
Closson, Kalysha
Klein, Marina
Cooper, Curtis
Burchell, Ann
Walmsley, Sharon
Kaida, Angela
Hogg, Robert
Viral suppression and viral rebound among young adults living with HIV in Canada
title Viral suppression and viral rebound among young adults living with HIV in Canada
title_full Viral suppression and viral rebound among young adults living with HIV in Canada
title_fullStr Viral suppression and viral rebound among young adults living with HIV in Canada
title_full_unstemmed Viral suppression and viral rebound among young adults living with HIV in Canada
title_short Viral suppression and viral rebound among young adults living with HIV in Canada
title_sort viral suppression and viral rebound among young adults living with hiv in canada
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6392935/
https://www.ncbi.nlm.nih.gov/pubmed/29851775
http://dx.doi.org/10.1097/MD.0000000000010562
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