Beyond undetectable
| Autor(a) principal: | |
|---|---|
| Data de Publicação: | 2023 |
| Outros Autores: | , , , , , , , , , , , , , , , |
| Tipo de documento: | Artigo |
| Idioma: | eng |
| Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
| Texto Completo: | http://hdl.handle.net/10362/155427 |
Resumo: | Funding Information: Financial support. This work was supported by the National Institutes of Health (grant numbers R01AI145453 to J. R. C.-M. and T32AI007387 to S. R. S.). Publisher Copyright: © 2023 The Author(s). Published by Oxford University Press on behalf of Infectious Diseases Society of America. |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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7160 |
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Beyond undetectablemodeling the clinical benefit of improved antiretroviral adherence in persons with human immunodeficiency virus with virologic suppressionadherencecoagulopathyHIVinflammationviral suppressionOncologyInfectious DiseasesSDG 3 - Good Health and Well-beingFunding Information: Financial support. This work was supported by the National Institutes of Health (grant numbers R01AI145453 to J. R. C.-M. and T32AI007387 to S. R. S.). Publisher Copyright: © 2023 The Author(s). Published by Oxford University Press on behalf of Infectious Diseases Society of America.Background: Incomplete antiretroviral therapy (ART) adherence has been linked to deleterious immunologic, inflammatory, and clinical consequences, even among virally suppressed (<50 copies/mL) persons with human immunodeficiency virus (PWH). The impact of improving adherence in the risk of severe non-AIDS events (SNAEs) and death in this population is unknown. Methods: We estimated the reduction in the risk of SNAEs or death resulting from an increase in ART adherence by (1) applying existing data on the association between adherence with high residual inflammation/coagulopathy in virally suppressed PWH, and (2) using a Cox proportional hazards model derived from changes in plasma interleukin 6 (IL-6) and D-dimer from 3 randomized clinical trials. Comparatively, assuming 100% ART adherence in a PWH who achieves viral suppression, we estimated the number of persons in whom a decrease in adherence to <100% would need to be observed for an additional SNAE or death event to occur during 3- and 5-year follow-up. Results: Increasing ART adherence to 100% in PWH who are suppressed on ART despite imperfect adherence translated into a 6%-37% reduction in the risk of SNAEs or death. Comparatively, based on an anticipated 12% increase in IL-6, 254 and 165 PWH would need to decrease their adherence from 100% to <100% for an additional event to occur over 3- and 5-year follow-up, respectively. Conclusions: Modest gains in ART adherence could have clinical benefits beyond virologic suppression. Increasing ART adherence (eg, via an intervention or switch to long-acting ART) in PWH who remain virally suppressed despite incomplete adherence should be evaluated.Comprehensive Health Research Centre (CHRC) - Pólo ENSPCentro de Investigação em Saúde Pública (CISP/PHRC)Escola Nacional de Saúde Pública (ENSP)RUNCastillo-Mancilla, Jose R.Morrow, MaryHunt, Peter W.Schnittman, Samuel R.Phillips, Andrew N.Baker, Jason V.Haberer, Jessica E.Janeiro, Maria JoaoAragao, FilipaCohen, CalMusinguzi, NicholasBrown, Todd T.Cavassini, MatthiasGlass, Tracy R.Serrano-Villar, SergioMawhinney, SamanthaSiedner, Mark2023-07-17T22:16:36Z2023-05-012023-05-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10362/155427eng2328-8957PURE: 66570292https://doi.org/10.1093/ofid/ofad230info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-03-11T05:37:59Zoai:run.unl.pt:10362/155427Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T03:56:03.701896Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
| dc.title.none.fl_str_mv |
Beyond undetectable modeling the clinical benefit of improved antiretroviral adherence in persons with human immunodeficiency virus with virologic suppression |
| title |
Beyond undetectable |
| spellingShingle |
Beyond undetectable Castillo-Mancilla, Jose R. adherence coagulopathy HIV inflammation viral suppression Oncology Infectious Diseases SDG 3 - Good Health and Well-being |
| title_short |
Beyond undetectable |
| title_full |
Beyond undetectable |
| title_fullStr |
Beyond undetectable |
| title_full_unstemmed |
Beyond undetectable |
| title_sort |
Beyond undetectable |
| author |
Castillo-Mancilla, Jose R. |
| author_facet |
Castillo-Mancilla, Jose R. Morrow, Mary Hunt, Peter W. Schnittman, Samuel R. Phillips, Andrew N. Baker, Jason V. Haberer, Jessica E. Janeiro, Maria Joao Aragao, Filipa Cohen, Cal Musinguzi, Nicholas Brown, Todd T. Cavassini, Matthias Glass, Tracy R. Serrano-Villar, Sergio Mawhinney, Samantha Siedner, Mark |
| author_role |
author |
| author2 |
Morrow, Mary Hunt, Peter W. Schnittman, Samuel R. Phillips, Andrew N. Baker, Jason V. Haberer, Jessica E. Janeiro, Maria Joao Aragao, Filipa Cohen, Cal Musinguzi, Nicholas Brown, Todd T. Cavassini, Matthias Glass, Tracy R. Serrano-Villar, Sergio Mawhinney, Samantha Siedner, Mark |
| author2_role |
author author author author author author author author author author author author author author author author |
| dc.contributor.none.fl_str_mv |
Comprehensive Health Research Centre (CHRC) - Pólo ENSP Centro de Investigação em Saúde Pública (CISP/PHRC) Escola Nacional de Saúde Pública (ENSP) RUN |
| dc.contributor.author.fl_str_mv |
Castillo-Mancilla, Jose R. Morrow, Mary Hunt, Peter W. Schnittman, Samuel R. Phillips, Andrew N. Baker, Jason V. Haberer, Jessica E. Janeiro, Maria Joao Aragao, Filipa Cohen, Cal Musinguzi, Nicholas Brown, Todd T. Cavassini, Matthias Glass, Tracy R. Serrano-Villar, Sergio Mawhinney, Samantha Siedner, Mark |
| dc.subject.por.fl_str_mv |
adherence coagulopathy HIV inflammation viral suppression Oncology Infectious Diseases SDG 3 - Good Health and Well-being |
| topic |
adherence coagulopathy HIV inflammation viral suppression Oncology Infectious Diseases SDG 3 - Good Health and Well-being |
| description |
Funding Information: Financial support. This work was supported by the National Institutes of Health (grant numbers R01AI145453 to J. R. C.-M. and T32AI007387 to S. R. S.). Publisher Copyright: © 2023 The Author(s). Published by Oxford University Press on behalf of Infectious Diseases Society of America. |
| publishDate |
2023 |
| dc.date.none.fl_str_mv |
2023-07-17T22:16:36Z 2023-05-01 2023-05-01T00:00:00Z |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
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article |
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publishedVersion |
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http://hdl.handle.net/10362/155427 |
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http://hdl.handle.net/10362/155427 |
| dc.language.iso.fl_str_mv |
eng |
| language |
eng |
| dc.relation.none.fl_str_mv |
2328-8957 PURE: 66570292 https://doi.org/10.1093/ofid/ofad230 |
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info:eu-repo/semantics/openAccess |
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openAccess |
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application/pdf |
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reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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