Increases in CD4+ T-cell count at antiretroviral therapy initiation among HIV-positive illicit drug users during a treatment-as-prevention initiative in Canada

Mimi Tran, Evan Wood, Thomas Kerr, Sophie Patterson, David Bangsberg, Huiru Dong, Silvia Guillemi, Julio S.G. Montaner, M. J. Milloy

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Although treatment-as-prevention (TasP) efforts are a new cornerstone of efforts to respond to the HIV/AIDS pandemic, their effects among people who use drugs (PWUD) have not been fully evaluated. This study characterizes temporal trends in CD4+ T-cell (CD4) count at ART initiation and rates of virological response among HIV-positive PWUD during a TasP initiative. Methods: We used data on individuals initiating ART within a prospective cohort of PWUD linked to comprehensive clinical records. Using multivariable linear regression, we evaluated the relationship between CD4 count prior to ART initiation and year of initiation and time to HIV-1 RNA viral load <50 copies/ml following initiation using Cox proportional hazards modelling. Results: Among 355 individuals, CD4 count at initiation rose from 130 to 330 cells/ml from 2005 to 2013. In multivariable regression, initiation year was significantly associated with higher CD4 count (β=29.5 cells per year, 95% CI 21.0, 37.9). Initiating ART at higher CD4 counts was significantly associated with optimal viral response (adjusted hazard ratio =1.13 per 100 cells/ml increase, 95% CI 1.05, 1.22). Conclusions: Increases in CD4 cell count at initiation over time was associated with superior virological response, consistent with the aims of the TasP initiative.

Original languageEnglish (US)
Pages (from-to)403-411
Number of pages9
JournalAntiviral Therapy
Volume22
Issue number5
DOIs
StatePublished - Jan 1 2017
Externally publishedYes

Fingerprint

Street Drugs
CD4 Lymphocyte Count
Drug Users
Canada
HIV
T-Lymphocytes
Therapeutics
Pharmaceutical Preparations
Pandemics
Viral Load
HIV-1
Linear Models
Acquired Immunodeficiency Syndrome
Cell Count
RNA

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)
  • Infectious Diseases

Cite this

Increases in CD4+ T-cell count at antiretroviral therapy initiation among HIV-positive illicit drug users during a treatment-as-prevention initiative in Canada. / Tran, Mimi; Wood, Evan; Kerr, Thomas; Patterson, Sophie; Bangsberg, David; Dong, Huiru; Guillemi, Silvia; Montaner, Julio S.G.; Milloy, M. J.

In: Antiviral Therapy, Vol. 22, No. 5, 01.01.2017, p. 403-411.

Research output: Contribution to journalArticle

Tran, Mimi ; Wood, Evan ; Kerr, Thomas ; Patterson, Sophie ; Bangsberg, David ; Dong, Huiru ; Guillemi, Silvia ; Montaner, Julio S.G. ; Milloy, M. J. / Increases in CD4+ T-cell count at antiretroviral therapy initiation among HIV-positive illicit drug users during a treatment-as-prevention initiative in Canada. In: Antiviral Therapy. 2017 ; Vol. 22, No. 5. pp. 403-411.
@article{24e7cd0b8e5c492689a4bf289e9c7acd,
title = "Increases in CD4+ T-cell count at antiretroviral therapy initiation among HIV-positive illicit drug users during a treatment-as-prevention initiative in Canada",
abstract = "Background: Although treatment-as-prevention (TasP) efforts are a new cornerstone of efforts to respond to the HIV/AIDS pandemic, their effects among people who use drugs (PWUD) have not been fully evaluated. This study characterizes temporal trends in CD4+ T-cell (CD4) count at ART initiation and rates of virological response among HIV-positive PWUD during a TasP initiative. Methods: We used data on individuals initiating ART within a prospective cohort of PWUD linked to comprehensive clinical records. Using multivariable linear regression, we evaluated the relationship between CD4 count prior to ART initiation and year of initiation and time to HIV-1 RNA viral load <50 copies/ml following initiation using Cox proportional hazards modelling. Results: Among 355 individuals, CD4 count at initiation rose from 130 to 330 cells/ml from 2005 to 2013. In multivariable regression, initiation year was significantly associated with higher CD4 count (β=29.5 cells per year, 95{\%} CI 21.0, 37.9). Initiating ART at higher CD4 counts was significantly associated with optimal viral response (adjusted hazard ratio =1.13 per 100 cells/ml increase, 95{\%} CI 1.05, 1.22). Conclusions: Increases in CD4 cell count at initiation over time was associated with superior virological response, consistent with the aims of the TasP initiative.",
author = "Mimi Tran and Evan Wood and Thomas Kerr and Sophie Patterson and David Bangsberg and Huiru Dong and Silvia Guillemi and Montaner, {Julio S.G.} and Milloy, {M. J.}",
year = "2017",
month = "1",
day = "1",
doi = "10.3851/IMP3145",
language = "English (US)",
volume = "22",
pages = "403--411",
journal = "Antiviral Therapy",
issn = "1359-6535",
publisher = "International Medical Press Ltd",
number = "5",

}

TY - JOUR

T1 - Increases in CD4+ T-cell count at antiretroviral therapy initiation among HIV-positive illicit drug users during a treatment-as-prevention initiative in Canada

AU - Tran, Mimi

AU - Wood, Evan

AU - Kerr, Thomas

AU - Patterson, Sophie

AU - Bangsberg, David

AU - Dong, Huiru

AU - Guillemi, Silvia

AU - Montaner, Julio S.G.

AU - Milloy, M. J.

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Background: Although treatment-as-prevention (TasP) efforts are a new cornerstone of efforts to respond to the HIV/AIDS pandemic, their effects among people who use drugs (PWUD) have not been fully evaluated. This study characterizes temporal trends in CD4+ T-cell (CD4) count at ART initiation and rates of virological response among HIV-positive PWUD during a TasP initiative. Methods: We used data on individuals initiating ART within a prospective cohort of PWUD linked to comprehensive clinical records. Using multivariable linear regression, we evaluated the relationship between CD4 count prior to ART initiation and year of initiation and time to HIV-1 RNA viral load <50 copies/ml following initiation using Cox proportional hazards modelling. Results: Among 355 individuals, CD4 count at initiation rose from 130 to 330 cells/ml from 2005 to 2013. In multivariable regression, initiation year was significantly associated with higher CD4 count (β=29.5 cells per year, 95% CI 21.0, 37.9). Initiating ART at higher CD4 counts was significantly associated with optimal viral response (adjusted hazard ratio =1.13 per 100 cells/ml increase, 95% CI 1.05, 1.22). Conclusions: Increases in CD4 cell count at initiation over time was associated with superior virological response, consistent with the aims of the TasP initiative.

AB - Background: Although treatment-as-prevention (TasP) efforts are a new cornerstone of efforts to respond to the HIV/AIDS pandemic, their effects among people who use drugs (PWUD) have not been fully evaluated. This study characterizes temporal trends in CD4+ T-cell (CD4) count at ART initiation and rates of virological response among HIV-positive PWUD during a TasP initiative. Methods: We used data on individuals initiating ART within a prospective cohort of PWUD linked to comprehensive clinical records. Using multivariable linear regression, we evaluated the relationship between CD4 count prior to ART initiation and year of initiation and time to HIV-1 RNA viral load <50 copies/ml following initiation using Cox proportional hazards modelling. Results: Among 355 individuals, CD4 count at initiation rose from 130 to 330 cells/ml from 2005 to 2013. In multivariable regression, initiation year was significantly associated with higher CD4 count (β=29.5 cells per year, 95% CI 21.0, 37.9). Initiating ART at higher CD4 counts was significantly associated with optimal viral response (adjusted hazard ratio =1.13 per 100 cells/ml increase, 95% CI 1.05, 1.22). Conclusions: Increases in CD4 cell count at initiation over time was associated with superior virological response, consistent with the aims of the TasP initiative.

UR - http://www.scopus.com/inward/record.url?scp=85034769845&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85034769845&partnerID=8YFLogxK

U2 - 10.3851/IMP3145

DO - 10.3851/IMP3145

M3 - Article

VL - 22

SP - 403

EP - 411

JO - Antiviral Therapy

JF - Antiviral Therapy

SN - 1359-6535

IS - 5

ER -