National characteristics and trends in antiretroviral treatment in Australia can be accurately estimated using a large clinical cohort

J Clin Epidemiol. 2018 Aug:100:82-91. doi: 10.1016/j.jclinepi.2018.04.015. Epub 2018 Apr 25.

Abstract

Objectives: Cohort studies are often used as a national surveillance tool to monitor trends in HIV treatment and morbidity outcomes. However, there are limited studies validating the accuracy of using cohorts as a representation of the overall HIV-positive population. We compared data from a large Australian HIV-positive cohort study (Australian HIV Observational Database [AHOD]) and a 10% longitudinal sample from Australia's subsidized prescription medication scheme (Pharmaceutical Benefits Scheme [PBS]) to assess the use of cohorts for providing representative data for surveillance and monitoring purposes.

Study design and setting: Basic demographics and treatment information from July 1, 2013, to March 31, 2016, were divided into half-yearly periods to compare HIV trends between AHOD (n = 2,488) and PBS (n = 18,409) patients.

Results: In both data sets, most patients were men, aged above 50 years, and primarily resided in New South Wales. Both data sets revealed a significant shift toward the increased use of integrase strand transfer inhibitors and a gradual decline in the use of protease inhibitors and nonnucleoside reverse-transcriptase inhibitors among the treated population in Australia. Similarly, a substantial increase in the use of once daily, single-tablet, fixed-dose combination regimens was also observed.

Conclusion: Our results show that observational cohort studies can serve as useful surrogate surveillance tools for monitoring patient characteristics and HIV treatment trends.

Keywords: Antiretroviral treatment; Cohort; HIV infection; Observational data; Surveillance; Treatment monitoring.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Anti-HIV Agents / administration & dosage*
  • Anti-HIV Agents / therapeutic use
  • Antiretroviral Therapy, Highly Active / trends*
  • Australia / epidemiology
  • Cohort Studies
  • Female
  • HIV Infections / drug therapy*
  • HIV Infections / epidemiology
  • Humans
  • Male
  • Middle Aged
  • Observational Studies as Topic
  • Population Surveillance
  • Prescriptions / statistics & numerical data
  • Protease Inhibitors / administration & dosage
  • Protease Inhibitors / therapeutic use
  • Reverse Transcriptase Inhibitors / administration & dosage
  • Reverse Transcriptase Inhibitors / therapeutic use
  • Young Adult

Substances

  • Anti-HIV Agents
  • Protease Inhibitors
  • Reverse Transcriptase Inhibitors