Health is improving for U.S. adults with HIV
■ Between 2000 and 2008, there was an increase in the proportion of adults in clinical care with suppressed HIV viral loads.
Significant health improvements have been made among HIV-infected adults in the United States, according to a study in the Sept. 4 issue of Annals of Internal Medicine.
Those advancements include an increase in the proportion of people taking highly active antiretroviral therapy, researchers said. The treatment consists of using at least three drugs to maximally suppress the HIV virus and stop progression of the disease.
In 2008, 83% of HIV-infected adults who received care were prescribed the therapy, up from 74% in 2000.
“This is good news for the HIV epidemic in the U.S., but there is room for improvement,” said lead author Keri N. Althoff, PhD, MPH.
“We need to continue to focus on linking HIV-infected adults into care and effective treatment, not only for the individual’s health, but to reduce the likelihood of transmission to others,” said Althoff, an assistant professor in the Dept. of Epidemiology at Johns Hopkins Bloomberg School of Public Health in Maryland.
An estimated 1.2 million Americans are living with HIV, and about 20% of them are unaware of their infection, according to the Centers for Disease Control and Prevention.
Researchers examined data on 45,529 U.S. adults 18 and older who have HIV and received clinical care for the illness between Jan. 1, 2000, and Dec. 31, 2008. The patients were part of the North American AIDS Cohort Collaboration on Research and Design, which is the continent’s largest collection of longitudinal HIV cohort studies. The NA-ACCORD has compiled data from more than 100 clinical sites in Canada and the U.S. since 2005.
Individuals were defined as receiving clinical care if at least one measurement was taken of their HIV viral load or their CD4 cell count during the study period. Researchers found that the overall proportion of participants with a suppressed viral load rose from 46% in 2000 to 72% in 2008 (link).
“In the HIV world, we know treatment is prevention,” Althoff said. “The more individuals we have on [highly active antiretroviral therapy] who can suppress their viral load decreases the likelihood that they could transmit the virus to another person.”
During the study period, there were 5,144 deaths, and 86% of those people had their CD4 cell count measured in the 18 months before dying. Data show that median CD4 cell count levels increased in that group between 2000 and 2008.
“This suggests that people with HIV are not dying of AIDS [as frequently] as they were 10 or 15 years ago,” Althoff said.
She said more research is needed to identify what conditions are causing death among people with HIV.