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BACKGROUND Results of cohort studies and mathematical models have suggested that increased coverage with highly active antiretroviral therapy (HAART) could reduce HIV transmission. We aimed to estimate the association between plasma HIV-1 viral load, HAART coverage, and number of new cases of HIV in the population of a Canadian province. METHODS We(More)
CONTEXT Current recommendations for initiation of antiretroviral therapy in patients infected with human immunodeficiency virus type 1 (HIV) are based on CD4 T-lymphocyte cell counts and plasma HIV RNA levels. The relative prognostic value of each marker following initiation of therapy has not been fully characterized. OBJECTIVE To describe rates of(More)
Continuing expansion of the HIV/AIDS pandemic has been recognised as an exceptional challenge to global health, international development, and world security. UNAIDS estimates that there were more than 38 million people living with HIV at the end of 2005, with just over 4 million new infections that year. While most new cases continue to emerge from(More)
OBJECTIVE To examine the relation between plasma HIV-1 RNA concentrations in the community and HIV incidence among injecting drug users. DESIGN Prospective cohort study. SETTING Inner city community in Vancouver, Canada. PARTICIPANTS Injecting drug users, with and without HIV, followed up every six months between 1 May 1996 and 30 June 2007. MAIN(More)
OBJECTIVE To examine the independent association of discordant virologic and immunologic responses to highly active antiretroviral therapy (HAART) with mortality. METHODS A population-based study of 1527 treatment-naive individuals initiating HAART used Cox proportional hazards modeling to determine the independent association of treatment response at 3(More)
AIMS Despite proven benefits of antiretroviral therapy (ART), many human immunodeficiency virus (HIV)-infected injection drug users (IDU) do not access treatment even in settings with free health care. We examined whether methadone maintenance therapy (MMT) increased initiation and adherence to ART among an IDU population with free health care. DESIGN We(More)
BACKGROUND Despite growing international pressure to provide HIV-1 treatment to less-developed countries, potential demographic and epidemiological impacts have yet to be characterised. We modelled the future impact of antiretroviral use in South Africa from 2000 to 2005. METHODS We produced a population projection model that assumed zero antiretroviral(More)
BACKGROUND There have been concerns that irreversible immune damage may result if highly active antiretroviral therapy (HAART) is initiated after the CD4 cell count declines to below 350 cells/microL; however, the role of antiretroviral adherence on CD4 cell count responses has not been well evaluated. METHODS We evaluated CD4 cell count responses of 1522(More)
OBJECTIVES The objectives of this study were to examine neighborhood measures of socioeconomic status and their effect on the risk of mortality among HIV-positive persons accessing and not accessing treatment, the effects of late access to treatment by CD4 cell count, and survival among those who accessed treatment. METHODS We limited our analysis to the(More)
BACKGROUND In the era before highly active antiretroviral therapy (HAART), socioeconomic status was associated with survival from HIV disease. We have explored socioeconomic status, access to triple therapy (HAART), and mortality in the context of a universal healthcare system. METHODS We evaluated 1408 individuals who initiated double or triple therapy(More)