Effectiveness of highly-active antiretroviral therapy by race/ethnicity

Michael J. Silverberg, Scott A. Wegner, Mark J. Milazzo, Rosemary G. McKaig, Carolyn F. Williams, Brian K. Agan, Adam W. Armstrong, Stephen J Gange, Clifton Hawkes, Robert J. O'Connell, Sunil K. Ahuja, Matthew J. Dolan

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: To determine the effectiveness of HAART by race/ethnicity. DESIGN: Prospective multicenter cohort study. METHODS: We studied 991 African-Americans and 911 European-Americans enrolled in the United States Military's Tri-Service AIDS Clinical Consortium Natural History Study who had dates of HIV seroconversion known within 5 years and followed between 1990 and 2002. We determined the rate of disease progression to AIDS and death for subjects in this cohort. Multivariable models evaluated race, pre-HAART (1990-1995) and HAART (1996-2002) eras, age, gender and military service. RESULTS: In the pre-HAART era, African-Americans had a statistically nonsignificant trend towards better outcomes: the relative hazards (RH) of AIDS and death for African-Americans compared to European-Americans were 0.85 [95% confidence interval (CI), 0.68-1.05] and 0.77 (95% CI, 0.55-1.08), respectively. In the HAART era, outcomes were similar by race: 1.17 (95% CI, 0.86-1.61) for AIDS and 1.11 (95% CI, 0.81-1.53) for death with overlapping Kaplan-Meier curves. Relative to the pre-HAART era, the adjusted RH of AIDS in the HAART era was 0.41 (95% CI, 0.31-0.54) and 0.30 (95% CI, 0.22-0.40) for African-American and European-American participants, respectively. Analogous RH for death were 0.55 (95% CI, 0.38-0.80) and 0.38 (95% CI, 0.27-0.54). The precipitous declines in AIDS and death in the HAART era were not statistically different by race. CONCLUSIONS: In a large multi-racial cohort with equal access to health care, HIV treatment outcomes by race/ethnicity were similar.

Original languageEnglish (US)
Pages (from-to)1531-1538
Number of pages8
JournalAIDS
Volume20
Issue number11
DOIs
StatePublished - Jul 2006

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Highly Active Antiretroviral Therapy
Confidence Intervals
Acquired Immunodeficiency Syndrome
African Americans
HIV Seropositivity
Health Services Accessibility
Natural History
Multicenter Studies
Disease Progression
Cohort Studies
HIV

Keywords

  • AIDS
  • Effectiveness
  • Highly-active antiretroviral therapy
  • HIV seroconversion
  • Race/ethnicity
  • Survival

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

Cite this

Silverberg, M. J., Wegner, S. A., Milazzo, M. J., McKaig, R. G., Williams, C. F., Agan, B. K., ... Dolan, M. J. (2006). Effectiveness of highly-active antiretroviral therapy by race/ethnicity. AIDS, 20(11), 1531-1538. https://doi.org/10.1097/01.aids.0000237369.41617.0f

Effectiveness of highly-active antiretroviral therapy by race/ethnicity. / Silverberg, Michael J.; Wegner, Scott A.; Milazzo, Mark J.; McKaig, Rosemary G.; Williams, Carolyn F.; Agan, Brian K.; Armstrong, Adam W.; Gange, Stephen J; Hawkes, Clifton; O'Connell, Robert J.; Ahuja, Sunil K.; Dolan, Matthew J.

In: AIDS, Vol. 20, No. 11, 07.2006, p. 1531-1538.

Research output: Contribution to journalArticle

Silverberg, MJ, Wegner, SA, Milazzo, MJ, McKaig, RG, Williams, CF, Agan, BK, Armstrong, AW, Gange, SJ, Hawkes, C, O'Connell, RJ, Ahuja, SK & Dolan, MJ 2006, 'Effectiveness of highly-active antiretroviral therapy by race/ethnicity', AIDS, vol. 20, no. 11, pp. 1531-1538. https://doi.org/10.1097/01.aids.0000237369.41617.0f
Silverberg MJ, Wegner SA, Milazzo MJ, McKaig RG, Williams CF, Agan BK et al. Effectiveness of highly-active antiretroviral therapy by race/ethnicity. AIDS. 2006 Jul;20(11):1531-1538. https://doi.org/10.1097/01.aids.0000237369.41617.0f
Silverberg, Michael J. ; Wegner, Scott A. ; Milazzo, Mark J. ; McKaig, Rosemary G. ; Williams, Carolyn F. ; Agan, Brian K. ; Armstrong, Adam W. ; Gange, Stephen J ; Hawkes, Clifton ; O'Connell, Robert J. ; Ahuja, Sunil K. ; Dolan, Matthew J. / Effectiveness of highly-active antiretroviral therapy by race/ethnicity. In: AIDS. 2006 ; Vol. 20, No. 11. pp. 1531-1538.
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abstract = "OBJECTIVE: To determine the effectiveness of HAART by race/ethnicity. DESIGN: Prospective multicenter cohort study. METHODS: We studied 991 African-Americans and 911 European-Americans enrolled in the United States Military's Tri-Service AIDS Clinical Consortium Natural History Study who had dates of HIV seroconversion known within 5 years and followed between 1990 and 2002. We determined the rate of disease progression to AIDS and death for subjects in this cohort. Multivariable models evaluated race, pre-HAART (1990-1995) and HAART (1996-2002) eras, age, gender and military service. RESULTS: In the pre-HAART era, African-Americans had a statistically nonsignificant trend towards better outcomes: the relative hazards (RH) of AIDS and death for African-Americans compared to European-Americans were 0.85 [95{\%} confidence interval (CI), 0.68-1.05] and 0.77 (95{\%} CI, 0.55-1.08), respectively. In the HAART era, outcomes were similar by race: 1.17 (95{\%} CI, 0.86-1.61) for AIDS and 1.11 (95{\%} CI, 0.81-1.53) for death with overlapping Kaplan-Meier curves. Relative to the pre-HAART era, the adjusted RH of AIDS in the HAART era was 0.41 (95{\%} CI, 0.31-0.54) and 0.30 (95{\%} CI, 0.22-0.40) for African-American and European-American participants, respectively. Analogous RH for death were 0.55 (95{\%} CI, 0.38-0.80) and 0.38 (95{\%} CI, 0.27-0.54). The precipitous declines in AIDS and death in the HAART era were not statistically different by race. CONCLUSIONS: In a large multi-racial cohort with equal access to health care, HIV treatment outcomes by race/ethnicity were similar.",
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AU - Williams, Carolyn F.

AU - Agan, Brian K.

AU - Armstrong, Adam W.

AU - Gange, Stephen J

AU - Hawkes, Clifton

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N2 - OBJECTIVE: To determine the effectiveness of HAART by race/ethnicity. DESIGN: Prospective multicenter cohort study. METHODS: We studied 991 African-Americans and 911 European-Americans enrolled in the United States Military's Tri-Service AIDS Clinical Consortium Natural History Study who had dates of HIV seroconversion known within 5 years and followed between 1990 and 2002. We determined the rate of disease progression to AIDS and death for subjects in this cohort. Multivariable models evaluated race, pre-HAART (1990-1995) and HAART (1996-2002) eras, age, gender and military service. RESULTS: In the pre-HAART era, African-Americans had a statistically nonsignificant trend towards better outcomes: the relative hazards (RH) of AIDS and death for African-Americans compared to European-Americans were 0.85 [95% confidence interval (CI), 0.68-1.05] and 0.77 (95% CI, 0.55-1.08), respectively. In the HAART era, outcomes were similar by race: 1.17 (95% CI, 0.86-1.61) for AIDS and 1.11 (95% CI, 0.81-1.53) for death with overlapping Kaplan-Meier curves. Relative to the pre-HAART era, the adjusted RH of AIDS in the HAART era was 0.41 (95% CI, 0.31-0.54) and 0.30 (95% CI, 0.22-0.40) for African-American and European-American participants, respectively. Analogous RH for death were 0.55 (95% CI, 0.38-0.80) and 0.38 (95% CI, 0.27-0.54). The precipitous declines in AIDS and death in the HAART era were not statistically different by race. CONCLUSIONS: In a large multi-racial cohort with equal access to health care, HIV treatment outcomes by race/ethnicity were similar.

AB - OBJECTIVE: To determine the effectiveness of HAART by race/ethnicity. DESIGN: Prospective multicenter cohort study. METHODS: We studied 991 African-Americans and 911 European-Americans enrolled in the United States Military's Tri-Service AIDS Clinical Consortium Natural History Study who had dates of HIV seroconversion known within 5 years and followed between 1990 and 2002. We determined the rate of disease progression to AIDS and death for subjects in this cohort. Multivariable models evaluated race, pre-HAART (1990-1995) and HAART (1996-2002) eras, age, gender and military service. RESULTS: In the pre-HAART era, African-Americans had a statistically nonsignificant trend towards better outcomes: the relative hazards (RH) of AIDS and death for African-Americans compared to European-Americans were 0.85 [95% confidence interval (CI), 0.68-1.05] and 0.77 (95% CI, 0.55-1.08), respectively. In the HAART era, outcomes were similar by race: 1.17 (95% CI, 0.86-1.61) for AIDS and 1.11 (95% CI, 0.81-1.53) for death with overlapping Kaplan-Meier curves. Relative to the pre-HAART era, the adjusted RH of AIDS in the HAART era was 0.41 (95% CI, 0.31-0.54) and 0.30 (95% CI, 0.22-0.40) for African-American and European-American participants, respectively. Analogous RH for death were 0.55 (95% CI, 0.38-0.80) and 0.38 (95% CI, 0.27-0.54). The precipitous declines in AIDS and death in the HAART era were not statistically different by race. CONCLUSIONS: In a large multi-racial cohort with equal access to health care, HIV treatment outcomes by race/ethnicity were similar.

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KW - HIV seroconversion

KW - Race/ethnicity

KW - Survival

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