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Verfasst von:Oldenburg, Catherine [VerfasserIn]   i
 Bor, Jacob [VerfasserIn]   i
 Harling, Guy [VerfasserIn]   i
 Tanser, Frank [VerfasserIn]   i
 Mutevedzi, Tinofa [VerfasserIn]   i
 Shahmanesh, Maryam [VerfasserIn]   i
 Seage, George R. [VerfasserIn]   i
 De Gruttola, Victor [VerfasserIn]   i
 Mimiaga, Matthew J. [VerfasserIn]   i
 Mayer, Kenneth H. [VerfasserIn]   i
 Pillay, Deenan [VerfasserIn]   i
 Bärnighausen, Till [VerfasserIn]   i
Titel:Impact of early antiretroviral therapy eligibility on HIV acquisition
Titelzusatz:household-level evidence from rural South Africa
Verf.angabe:Catherine E. Oldenburg, Jacob Bor, Guy Harling, Frank Tanser, Tinofa Mutevedzi, Maryam Shahmanesh, George R. Seage, Victor De Gruttola, Matthew J. Mimiaga, Kenneth H. Mayer, Deenan Pillay and Till Bärnighausen
E-Jahr:2018
Jahr:[March 13, 2018]
Umfang:9 S.
Illustrationen:Diagramme
Fussnoten:Gesehen am 24.03.2020
Titel Quelle:Enthalten in: AIDS <London>
Ort Quelle:London [u.a.] : Lippincott Williams & Wilkins, 1987
Jahr Quelle:2018
Band/Heft Quelle:32(2018), 5, Seite 635-643
ISSN Quelle:1473-5571
Abstract:Objectives: We investigate the effect of immediate antiretroviral therapy (ART) eligibility on HIV incidence among HIV-uninfected household members. - Design: Regression discontinuity study arising from a population-based cohort. - Methods: Household members of patients seeking care at the Hlabisa HIV Treatment and Care Programme in rural KwaZulu-Natal South Africa between January 2007 and August 2011 with CD4+ cell counts up to 350 cells/μl were eligible for inclusion if they had at least two HIV tests and were HIV-uninfected at the time the index patient linked to care (N = 4115). Regression discontinuity was used to assess the intention-to-treat effect of immediate versus delayed ART eligibility on HIV incidence among household members. Exploiting the CD4+ cell count-based threshold rule for ART initiation (CD4+ < 200 cells/μl until August 2011), we used Cox proportional hazards models to compare outcomes for household members of patients who presented for care with CD4+ cell counts just above versus just below the ART initiation threshold. - Results: Characteristics of household members of index patients initiating HIV care were balanced between those with an index patient immediately eligible for ART (N = 2489) versus delayed for ART (N = 1626). There were 337 incident HIV infections among household members, corresponding to an HIV incidence of 2.4 infections per 100 person-years (95% confidence interval 2.5-3.1). Immediate eligibility for treatment reduced HIV incidence in households by 47% in our optimal estimate (hazard ratio = 0.53, 95% confidence interval 0.30-0.96), and by 32-60% in alternate specifications of the model. - Conclusion: Immediate eligibility of ART led to substantial reductions in household-level HIV incidence.
DOI:doi:10.1097/QAD.0000000000001737
URL:Bitte beachten Sie: Dies ist ein Bibliographieeintrag. Ein Volltextzugriff für Mitglieder der Universität besteht hier nur, falls für die entsprechende Zeitschrift/den entsprechenden Sammelband ein Abonnement besteht oder es sich um einen OpenAccess-Titel handelt.

Volltext: https://doi.org/10.1097/QAD.0000000000001737
 Volltext: https://journals.lww.com/aidsonline/FullText/2018/03130/Impact_of_early_antiretroviral_therapy_eligibility.12.aspx
 DOI: https://doi.org/10.1097/QAD.0000000000001737
Datenträger:Online-Ressource
Sprache:eng
K10plus-PPN:1693193558
Verknüpfungen:→ Zeitschrift

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