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Abacavir and risk of myocardial infarction in HIV-infected patients on highly active antiretroviral therapy: a population-based nationwide cohort study.

https://arctichealth.org/en/permalink/ahliterature99479
Source
HIV Med. 2010 Feb;11(2):130-6
Publication Type
Article
Date
Feb-2010
Author
Niels Obel
D K Farkas
G. Kronborg
C S Larsen
G. Pedersen
A. Riis
C. Pedersen
J. Gerstoft
H T Sørensen
Author Affiliation
Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Denmark. niels.obel@rh.regionh.dk
Source
HIV Med. 2010 Feb;11(2):130-6
Date
Feb-2010
Language
English
Publication Type
Article
Keywords
Adult
Anti-HIV Agents - adverse effects
Antiretroviral Therapy, Highly Active
Comorbidity
Denmark - epidemiology
Dideoxynucleosides - adverse effects
Epidemiologic Methods
Female
HIV Infections - drug therapy
Hospitalization - statistics & numerical data
Humans
Male
Middle Aged
Myocardial Infarction - chemically induced - epidemiology
Myocardial Ischemia - epidemiology
Proportional Hazards Models
Time Factors
Abstract
OBJECTIVE: The aim of the study was to examine whether exposure to abacavir increases the risk for myocardial infarction (MI). DESIGN, SETTING AND SUBJECTS: This was a prospective nationwide cohort study which included all Danish HIV-infected patients on highly active antiretroviral therapy (HAART) from 1995 to 2005 (N = 2952). Data on hospitalization for MI and comorbidity were obtained from Danish medical databases. Hospitalization rates for MI after HAART initiation were calculated for patients who used abacavir and those who did not. We used Cox's regression to compute incidence rate ratios (IRR) as a measure of relative risk for MI, while controlling for potential confounders (as separate variables and via propensity score) including comorbidity. MAIN OUTCOME: Relative risk of hospitalization with MI in abacavir users compared with abacavir nonusers. RESULTS: Hospitalization rates for MI were 2.4/1000 person-years (PYR) [95% confidence interval (CI) 1.7-3.4] for abacavir nonusers and 5.7/1000 PYR (95% CI 4.1-7.9) for abacavir users. The risk of MI increased after initiation of abacavir [unadjusted IRR = 2.22 (95% CI 1.31-3.76); IRR adjusted for confounders = 2.00 (95% CI 1.10-3.64); IRR adjusted for propensity score = 2.00 (95% CI 1.07-3.76)]. This effect was also observed among patients initiating abacavir within 2 years after the start of HAART and among patients who started abacavir as part of a triple nucleoside reverse transcriptase inhibitor (NRTI) regimen. CONCLUSIONS: We confirmed the association between abacavir use and increased risk of MI. Further studies are needed to control for potential confounding not measured in research to date.
PubMed ID
19682101 View in PubMed
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Access and utilization of HIV treatment and services among women sex workers in Vancouver's Downtown Eastside.

https://arctichealth.org/en/permalink/ahliterature174373
Source
J Urban Health. 2005 Sep;82(3):488-97
Publication Type
Article
Date
Sep-2005
Author
Kate Shannon
Vicki Bright
Janice Duddy
Mark W Tyndall
Author Affiliation
BC Centre for Excellence in HIV AIDS, St. Paul's Hospital, 1081 Burrard Street, Vancouver, British Columbia, Canada V6Z 1Y6.
Source
J Urban Health. 2005 Sep;82(3):488-97
Date
Sep-2005
Language
English
Publication Type
Article
Keywords
Adult
Antiretroviral Therapy, Highly Active - utilization
Canada - epidemiology
Community Health Services - supply & distribution - utilization
Female
HIV Infections - epidemiology - therapy
Health Services Accessibility
Hepatitis C - epidemiology
Humans
Middle Aged
Poverty Areas
Prostitution
Substance-Related Disorders - epidemiology
Urban Population
Abstract
Many HIV-infected women are not realizing the benefits of highly active antiretroviral therapy (HAART) despite significant advancements in treatment. Women in Vancouver's Downtown Eastside (DTES) are highly marginalized and struggle with multiple morbidities, unstable housing, addiction, survival sex, and elevated risk of sexual and drug-related harms, including HIV infection. Although recent studies have identified the heightened risk of HIV infection among women engaged in sex work and injection drug use, the uptake of HIV care among this population has received little attention. The objectives of this study are to evaluate the needs of women engaged in survival sex work and to assess utilization and acceptance of HAART. During November 2003, a baseline needs assessment was conducted among 159 women through a low-threshold drop-in centre servicing street-level sex workers in Vancouver. Cross-sectional data were used to describe the sociodemographic characteristics, drug use patterns, HIV/hepatitis C virus (HCV) testing and status, and attitudes towards HAART. High rates of cocaine injection, heroin injection, and smokeable crack cocaine use reflect the vulnerable and chaotic nature of this population. Although preliminary findings suggest an overall high uptake of health and social services, there was limited attention to HIV care with only 9% of the women on HAART. Self-reported barriers to accessing treatment were largely attributed to misinformation and misconceptions about treatment. Given the acceptability of accessing HAART through community interventions and women specific services, this study highlights the potential to reach this highly marginalized group and provides valuable baseline information on a population that has remained largely outside consistent HIV care.
Notes
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PubMed ID
15944404 View in PubMed
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Adherence and plasma HIV RNA responses to highly active antiretroviral therapy among HIV-1 infected injection drug users.

https://arctichealth.org/en/permalink/ahliterature183497
Source
CMAJ. 2003 Sep 30;169(7):656-61
Publication Type
Article
Date
Sep-30-2003
Author
Evan Wood
Julio S G Montaner
Benita Yip
Mark W Tyndall
Martin T Schechter
Michael V O'Shaughnessy
Robert S Hogg
Author Affiliation
British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, BC. ewood@hivnet.ubc.ca
Source
CMAJ. 2003 Sep 30;169(7):656-61
Date
Sep-30-2003
Language
English
Publication Type
Article
Keywords
Adult
Antiretroviral Therapy, Highly Active
British Columbia
CD4 Lymphocyte Count
Female
HIV Infections - blood - drug therapy - etiology
HIV-1
Humans
Male
Patient compliance
RNA, Viral - blood - drug effects
Substance Abuse, Intravenous
Abstract
The benefits of highly active antiretroviral therapy (HAART) for the treatment of HIV infection are well documented, but concerns regarding access and adherence to HAART are growing. We evaluated virological responses to HAART among HIV-1 infected patients who were injection drug users (IDUs) in a population-based setting where HIV/AIDS care is delivered free of charge.
We evaluated previously untreated HIV-1 infected men and women who initiated HAART between Aug. 1, 1996, and July 31, 2000, and who were followed until Mar. 31, 2002, in a province-wide HIV treatment program. We used Kaplan-Meier methods and Cox proportional hazards regression in our evaluation of time to suppression (i.e., less than 500 copies/mL) and rebound (i.e., 500 copies/mL or more) of plasma HIV-1 RNA, with patients stratified according to whether or not they had a history of injection drug use.
Overall, 1422 patients initiated HAART during the study period, of whom 359 (25.2%) were IDUs. In Kaplan-Meier analyses, the cumulative suppression rate at 12 months after initiation of HAART was 70.8% for non-IDUs and 51.4% for IDUs (p 0.1).
Non-IDUs and IDUs had similar rates of HIV-1 RNA suppression and rebound after the initiation of HAART, once lower levels of adherence were taken into account. Nevertheless, the lower virological response rates among IDUs suggest that, unless interventions are undertaken to improve adherence, these patients may experience elevated rates of disease progression and use of medical services in our setting.
Notes
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PubMed ID
14517122 View in PubMed
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Adherence and plasma HIV RNA response to antiretroviral therapy among HIV-seropositive injection drug users in a Canadian setting.

https://arctichealth.org/en/permalink/ahliterature135422
Source
AIDS Care. 2011 Aug;23(8):980-7
Publication Type
Article
Date
Aug-2011
Author
Seonaid Nolan
M-J Milloy
Ruth Zhang
Thomas Kerr
Robert S Hogg
Julio S G Montaner
Evan Wood
Author Affiliation
BC Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada.
Source
AIDS Care. 2011 Aug;23(8):980-7
Date
Aug-2011
Language
English
Publication Type
Article
Keywords
Adult
Anti-HIV Agents - therapeutic use
Antiretroviral Therapy, Highly Active - statistics & numerical data
Canada
Cohort Studies
Drug Users - psychology
Female
HIV Infections - blood - drug therapy - psychology
Humans
Kaplan-Meier Estimate
Male
Medication Adherence
Middle Aged
Patient compliance
Proportional Hazards Models
RNA, Viral - blood - drug effects
Substance Abuse, Intravenous
Treatment Outcome
Young Adult
Abstract
HIV-positive individuals who use injection drugs (IDU) may have lower rates of adherence to highly active antiretroviral therapy (ART). However, previous studies of factors associated with adherence to ART among IDU have been limited primarily to samples drawn from clinical settings and in areas with financial barriers to healthcare.We evaluated patterns of ART adherence and rates of plasma HIV RNA response among a Canadian cohort of community-recruited IDU. Using data from a community-recruited cohort of antiretroviral-naive HIV-infected IDU, we investigated ART adherence patterns based on prescription refill compliance and factors associated with time to plasma HIV-1 RNA suppression (
PubMed ID
21480010 View in PubMed
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Adherence to antiretroviral medications among persons who inject drugs in transitional, low and middle income countries: an international systematic review.

https://arctichealth.org/en/permalink/ahliterature268956
Source
AIDS Behav. 2015 Apr;19(4):575-83
Publication Type
Article
Date
Apr-2015
Author
Jonathan Feelemyer
Don Des Jarlais
Kamyar Arasteh
Anneli Uusküla
Source
AIDS Behav. 2015 Apr;19(4):575-83
Date
Apr-2015
Language
English
Publication Type
Article
Keywords
Antiretroviral Therapy, Highly Active
Brazil - epidemiology
China - epidemiology
Comorbidity
Drug Users - statistics & numerical data
Estonia - epidemiology
HIV Infections - drug therapy - epidemiology
Humans
India - epidemiology
Indonesia - epidemiology
Medication Adherence - statistics & numerical data
Russia - epidemiology
Substance Abuse, Intravenous - epidemiology
Vietnam - epidemiology
Abstract
Adherence to antiretroviral (ART) medication is vital to reducing morbidity and mortality among HIV positive persons. People who inject drugs (PWID) are at high risk for HIV infection in transitional/low/middle income countries (TLMIC). We conducted a systematic review of studies reporting adherence to ART among persons with active injection drug use and/or histories of injection drug use in TLMIC. Meta-regression was performed to examine relationships between location, adherence measurements, and follow-up period. Fifteen studies were included from seven countries. Adherence levels ranged from 33 to 97 %; mean weighted adherence was 72 %. ART adherence was associated with different methods of measuring adherence and studies conducted in Eastern Europe and East Asia. The great heterogeneity observed precludes generalization to TLMIC as a whole. Given the critical importance of ART adherence more research is needed on ART adherence among PWID in TLMIC, including the use of standardized methods for reporting adherence to ART.
Notes
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PubMed ID
25331268 View in PubMed
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Adherence to national guidelines for initiation of antiretroviral regimens in HIV patients: a Danish nationwide study.

https://arctichealth.org/en/permalink/ahliterature137186
Source
Br J Clin Pharmacol. 2011 Jul;72(1):116-24
Publication Type
Article
Date
Jul-2011
Author
Tonny S Petersen
Stig E Andersen
January Gerstoft
Kristina Thorsteinsson
Carsten S Larsen
Gitte Pedersen
Court Pedersen
Niels Obel
Author Affiliation
Department of Clinical Pharmacology, Copenhagen University Hospital, Bispebjerg Hospital, Bispebjerg Bakke 23, 2400 Copenhagen, Denmark. tsp@person.dk
Source
Br J Clin Pharmacol. 2011 Jul;72(1):116-24
Date
Jul-2011
Language
English
Publication Type
Article
Keywords
Adult
Anti-HIV Agents - administration & dosage
Antiretroviral Therapy, Highly Active - methods - standards
Cohort Studies
Denmark
Drug Administration Schedule
Female
Guideline Adherence
HIV Infections - drug therapy
Humans
Male
Patient compliance
Practice Guidelines as Topic
Regression Analysis
State Medicine
Treatment Outcome
Abstract
To determine the adherence to the national guidelines for start of highly active antiretroviral treatment (HAART) in HIV infected patients.
We used a Danish nationwide cohort of HIV infected patients to calculate the fraction of patients who in the period 1997-2006 started HAART according to the guidelines from The Danish Society of Infectious Diseases. We used Kaplan-Meier tables to estimate time from fulfilling the criteria for start of HAART to initiation of the treatment. Cox regression and logistic regression was used to identify risk factors for delayed initiation of treatment and chance of being included in clinical trials.
The study included 3223 patients, 74% of whom initiated HAART in the study period. Ninety-four% fulfilled the criteria for start of HAART, with minor differences over calendar periods. Ninety-four% initiated a recommended regimen or were included in a clinical trial. Intravenous drug use predicted initiation of a non-recommended regimen and delay in start of HAART, while non-Caucasians were less likely to be included in clinical trials.
In a Western world setting, the adherence to national guidelines for start of HAART can be high. We suggest that simplicity of the guidelines, centralization of treatment and involvement of local clinicians in the development of guidelines are of major importance for high adherence to treatment guidelines.
Notes
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PubMed ID
21306418 View in PubMed
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Adherence to treatment in Swedish HIV-infected patients.

https://arctichealth.org/en/permalink/ahliterature79390
Source
J Clin Pharm Ther. 2006 Dec;31(6):605-16
Publication Type
Article
Date
Dec-2006
Author
Södergård B.
Halvarsson M.
Tully M P
Mindouri S.
Nordström M-L
Lindbäck S.
Sönnerborg A.
Lindblad A K
Author Affiliation
Pharmaceutical Outcomes Research Group, Department of Pharmacy, Uppsala University, Uppsala, Sweden. bjorn.sodergard@farmaci.uu.se
Source
J Clin Pharm Ther. 2006 Dec;31(6):605-16
Date
Dec-2006
Language
English
Publication Type
Article
Keywords
Adult
Antiretroviral Therapy, Highly Active
Female
HIV Infections - drug therapy
Humans
Male
Middle Aged
Multivariate Analysis
Patient compliance
Social Support
Sweden
Abstract
OBJECTIVES: The objectives were to assess the prevalence of adherence to antiretroviral treatment in Swedish human immunodeficiency virus (HIV)-infected patients and to evaluate factors associated with adherence. METHODS: All HIV-treated patients, who attended one of 30 (of a total of 32) Swedish infectious diseases clinics, during 7 months, were asked to complete an anonymous questionnaire containing the 9-item Morisky Medication Adherence Scale (MMAS) and questions about other factors potentially affecting adherence. The summary score of MMAS ranges from 1 to 13, where 13 indicates perfect adherence; patients scoring 11 or above (corresponding to 95% adherence level) were classified as 'adherent'. RESULTS AND DISCUSSION: In total 946 patients participated (response rate 97.5%). The proportion of patients who reported not missing a dose during the day prior to the completion of the questionnaire was 97% and the proportion classified as 'adherent' was 63%. 'Adherent' patients were more likely to have a good relationship with their health care professionals (P
PubMed ID
17176366 View in PubMed
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AIDS could dominate Russian budget by 2020.

https://arctichealth.org/en/permalink/ahliterature188655
Source
Bull World Health Organ. 2002;80(8):686-7
Publication Type
Article
Date
2002

AIDS in 2003: moving forward, falling back.

https://arctichealth.org/en/permalink/ahliterature186012
Source
Can J Public Health. 2003 Mar-Apr;94(2):85-7
Publication Type
Article
Author
Patricia M Spittal
Martin T Schechter
Source
Can J Public Health. 2003 Mar-Apr;94(2):85-7
Language
English
Publication Type
Article
Keywords
Acquired Immunodeficiency Syndrome - drug therapy - mortality - prevention & control
Antiretroviral Therapy, Highly Active
Canada - epidemiology
Disease Outbreaks
Humans
Prevalence
World Health
Notes
Comment On: Can J Public Health. 2003 Mar-Apr;94(2):93-712675163
Comment On: Can J Public Health. 2003 Mar-Apr;94(2):135-912675171
PubMed ID
12675161 View in PubMed
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262 records – page 1 of 27.