Remote sensing of HIV care programmes using centrally collected laboratory results: Can we monitor ART programme effectiveness?

Morrow, Carl; Munro, Alison; Wilke, Marisa; Stark, Ruth; Wood, Robin

doi:10.7196/samj.5625

Cited by 3 publications

(3 citation statements)

References 10 publications

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“…We used data from the Southern African Catholic Bishops Conference cohort to estimate mean age ± SD (37 ± 10 years), sex distribution (33% male), HIV RNA level distributions (46% with an HIV RNA level of > 100 000 copies/mL), and mean CD4 + T-cell count at ART initiation (112–178 cells/µL during 2004–2011) of the simulated cohorts [22, 23]. HIV disease natural history parameters, including chronic AIDS mortality and opportunistic disease incidence and mortality, were taken from the Cape Town AIDS Cohort [17].…”

Section: Methodsmentioning

confidence: 99%

“…These analyses included alternative inputs reflecting uncertainty in numbers of persons initiating ART each year [1], mean CD4 + T-cell count upon ART initiation [22, 23], CD4 + T-cell count and HIV RNA level monitoring availability [20, 31, 32], ART efficacy [26, 33–37], second-line ART availability [21], and ART program retention (Supplementary Materials) [14, 15]. We also simultaneously changed all of these variables to generate best- and worst-case scenarios reflecting uncertainty in all base-case inputs.…”

Section: Methodsmentioning

confidence: 99%

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The Survival Benefits of Antiretroviral Therapy in South Africa

April

Wood

Berkowitz³

et al. 2013

The Journal of Infectious Diseases

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Background. We sought to quantify the survival benefits attributable to antiretroviral therapy (ART) in South Africa since 2004.Methods. We used the Cost-Effectiveness of Preventing AIDS Complications–International model (CEPAC) to simulate 8 cohorts of human immunodeficiency virus (HIV)–infected patients initiating ART each year during 2004–2011. Model inputs included cohort-specific mean CD4+ T-cell count at ART initiation (112–178 cells/µL), 24-week ART suppressive efficacy (78%), second-line ART availability (2.4% of ART recipients), and cohort-specific 36-month retention rate (55%–71%). CEPAC simulated survival twice for each cohort, once with and once without ART. The sum of the products of per capita survival differences and the total numbers of persons initiating ART for each cohort yielded the total survival benefits.Results. Lifetime per capita survival benefits ranged from 9.3 to 10.2 life-years across the 8 cohorts. Total estimated population lifetime survival benefit for all persons starting ART during 2004–2011 was 21.7 million life-years, of which 2.8 million life-years (12.7%) had been realized by December 2012. By 2030, benefits reached 17.9 million life-years under current policies, 21.7 million life-years with universal second-line ART, 23.3 million life-years with increased linkage to care of eligible untreated patients, and 28.0 million life-years with both linkage to care and universal second-line ART.Conclusions. We found dramatic past and potential future survival benefits attributable to ART, justifying international support of ART rollout in South Africa.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

The Survival Benefits of Antiretroviral Therapy in South Africa

April

Wood

Berkowitz³

et al. 2013

The Journal of Infectious Diseases

Self Cite

View full text Add to dashboard Cite

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“…Data on the routine monitoring of patients had great utility for assessment of the population health; therefore, the effectiveness of the cART program must be continuously evaluated. Reported laboratory data are useful to achieve this goal, easy to collect, as well as reliable and scalable from a single clinic to an entire population 30 . We recognize that the retrospective design of our analysis and the absence of certain data, as adherence to therapy for individuals analyzed, proportion of individuals diagnosed and undiagnosed at our region, as well as proportion of lost during the follow-up period due to death or migration, are some limitations of this study.…”

Section: Variablesmentioning

confidence: 99%

Cascade of care for people living with HIV infection in Southern Brazil: results from a public health network

et al. 2018

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A cascata de cuidados para pessoas vivendo com a infecção pelo HIV no Sul do Brasil: resultados obtidos em uma rede pública de saúde Serie de cuidados para personas que viven con una infección de VIH en el sur de Brasil: resultados en una red pública de salud AbstractThe cascade of care for people living with HIV infection (PLHIV) describes steps in diagnosis, linkage and retention in care, as well as the provision and success of combination antiretroviral therapy (cART). The aim of this study was to evaluate the rates regarding the retention in care, on cART, and suppressed viral load for PLHIV attended at a Brazilian public health network. Data on PLHIV from 116 cities of Paraná, Southern Brazil, attended from 2012 to 2015, were retrospectively collected through the Laboratory Tests Control System (SISCEL). The number of PLHIV related to care increased about 22.5% from 2012 to 2015 (4,106 to 5,030 individuals). The proportion of PLHIV retained in care showed a trend toward stabilization around 81.7-86.9%. Every year, the use of cART increased up to 90.3% for PLHIV retained in care. Viral load suppression was achieved by 72.8% of patients on cART and 57.1% by those linked to care. Retention in care and HIV viral suppression were more likely to occur in older PLHIV than younger ones; similarly, patients living in medium-sized cities were more susceptible to these factors than in large-or small-sized cities. In conclusion, the study showed a high level of retention in care and HIV suppression on cART, as well as emphasized that current efforts for treating already-infected PLHIV remain a challenge for our health public institutions and may contribute to highlight steps for improvement of the HIV cascade of care in our population. HIV; Highly Active Antiretroviral Therapy; Sustained Virologic ResponseCorrespondence E. M. V. Reiche

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A systematic review of the geospatial barriers to antiretroviral initiation, adherence and viral suppression among people living with HIV

et al. 2019

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Background With the emergence of antiretroviral therapy (ART), Treatment as Prevention (TasP) has become the cornerstone of both HIV clinical care and HIV prevention. However, despite the efficacy of treatment-based programs and policies, structural barriers to ART initiation, adherence and viral suppression have the potential to reduce TasP effectiveness. These barriers have been studied using Geographic Information Systems (GIS). While previous reviews have examined the use of GIS for HIV testing – an essential antecedent to clinical care – to date, no reviews have summarised the research with respect to other ART-related outcomes. Methods: Therefore, the present review leveraged the PubMed database to identify studies that leveraged GIS to examine the barriers to ART initiation, adherence and viral suppression, with the overall goal of understanding how GIS has been used (and might continue to be used) to better study TasP outcomes. Joanna Briggs Institute criteria were used for the critical appraisal of included studies. Results: In total, 33 relevant studies were identified, excluding those not utilising explicit GIS methodology or not examining TasP-related outcomes. Conclusions: Findings highlight geospatial variation in ART success and inequitable distribution of HIV care in racially segregated, economically disadvantaged, and, by some accounts, increasingly rural areas – particularly in the United States. Furthermore, this review highlights the utility and current limitations of using GIS to monitor health outcomes related to ART and the need for careful planning of resources with respect to the geospatial movement and location of people living with HIV (PLWH).

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Remote sensing of HIV care programmes using centrally collected laboratory results: Can we monitor ART programme effectiveness?

Cited by 3 publications

References 10 publications

The Survival Benefits of Antiretroviral Therapy in South Africa

The Survival Benefits of Antiretroviral Therapy in South Africa

Cascade of care for people living with HIV infection in Southern Brazil: results from a public health network

A systematic review of the geospatial barriers to antiretroviral initiation, adherence and viral suppression among people living with HIV

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