Different transmission routes and the risk of advanced HIV disease: A systematic review and network meta-analysis of observational studies
Background: A substantial proportion of people living with HIV (PLHIV) present for care with advanced HIV disease (AHD), which may result in difficulty reaching the “90–90–90” target to end AIDS in 2030. We assessed the risk of AHD for different transmission routes to summarize the evidence for prio...
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| Format: | Article |
| Language: | English |
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Elsevier
2019-11-01
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| Series: | EClinicalMedicine |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589537019301853 |
| _version_ | 1818335543963942912 |
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| author | Qiaosen Chen Ding Zeng Yangyang She Yuhan Lyu Xiao Gong Matthew J. Feinstein Yi Yang Hongbo Jiang |
| author_facet | Qiaosen Chen Ding Zeng Yangyang She Yuhan Lyu Xiao Gong Matthew J. Feinstein Yi Yang Hongbo Jiang |
| author_sort | Qiaosen Chen |
| collection | DOAJ |
| description | Background: A substantial proportion of people living with HIV (PLHIV) present for care with advanced HIV disease (AHD), which may result in difficulty reaching the “90–90–90” target to end AIDS in 2030. We assessed the risk of AHD for different transmission routes to summarize the evidence for priority prevention strategies for key populations. Methods: Observational studies published before September 10th, 2019 in the PubMed, EMBASE, Web of Science and Chinese electronic databases were analysed. The outcomes of interest were the number of PLHIV and AHD patients and their associated transmission routes. We assessed the risk of AHD among the different transmission routes using the multi-armed network meta-analysis based on the Bayesian method. The associations between AHD and regional policies for sex work and compulsory drug treatment were estimated using ecological linear regression. Findings: One hundred and one articles were included, covering 1,297,872 PLHIV with 478,830 patients who developed AHD. The network analysis revealed that among PLHIV, heterosexual contact was associated with the highest risk of AHD, followed by injection drug use (odds ratio [OR]=0•56, 95% credible interval [CrI] 0•47–0•68), and men who have sex with men (OR=0•54, 95% CrI 0•46–0•63). Regions that criminalized sex work and compulsory drug treatment had higher risks for AHD than those that did not. Interpretation: Our findings suggest HC is at a higher risk of AHD compared to IDU and MSM. This justifies the need to expand prevention campaigns and maintain efforts to increase HIV testing in the heterosexual population. |
| first_indexed | 2024-12-13T14:25:06Z |
| format | Article |
| id | doaj.art-b993c02317a74a67a9c63828fdd23517 |
| institution | Directory Open Access Journal |
| issn | 2589-5370 |
| language | English |
| last_indexed | 2024-12-13T14:25:06Z |
| publishDate | 2019-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | EClinicalMedicine |
| spelling | doaj.art-b993c02317a74a67a9c63828fdd235172022-12-21T23:41:58ZengElsevierEClinicalMedicine2589-53702019-11-0116121128Different transmission routes and the risk of advanced HIV disease: A systematic review and network meta-analysis of observational studiesQiaosen Chen0Ding Zeng1Yangyang She2Yuhan Lyu3Xiao Gong4Matthew J. Feinstein5Yi Yang6Hongbo Jiang7Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, ChinaDepartment of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, ChinaThe Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaSchool of Health Science, Guangdong Pharmaceutical University, Guangzhou, ChinaDepartment of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, ChinaDepartments of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, United StatesDepartment of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China; Co-Corresponding to: Yi Yang Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou 510310, China.Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China; Corresponding to: Hongbo Jiang Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou 510310, China.Background: A substantial proportion of people living with HIV (PLHIV) present for care with advanced HIV disease (AHD), which may result in difficulty reaching the “90–90–90” target to end AIDS in 2030. We assessed the risk of AHD for different transmission routes to summarize the evidence for priority prevention strategies for key populations. Methods: Observational studies published before September 10th, 2019 in the PubMed, EMBASE, Web of Science and Chinese electronic databases were analysed. The outcomes of interest were the number of PLHIV and AHD patients and their associated transmission routes. We assessed the risk of AHD among the different transmission routes using the multi-armed network meta-analysis based on the Bayesian method. The associations between AHD and regional policies for sex work and compulsory drug treatment were estimated using ecological linear regression. Findings: One hundred and one articles were included, covering 1,297,872 PLHIV with 478,830 patients who developed AHD. The network analysis revealed that among PLHIV, heterosexual contact was associated with the highest risk of AHD, followed by injection drug use (odds ratio [OR]=0•56, 95% credible interval [CrI] 0•47–0•68), and men who have sex with men (OR=0•54, 95% CrI 0•46–0•63). Regions that criminalized sex work and compulsory drug treatment had higher risks for AHD than those that did not. Interpretation: Our findings suggest HC is at a higher risk of AHD compared to IDU and MSM. This justifies the need to expand prevention campaigns and maintain efforts to increase HIV testing in the heterosexual population.http://www.sciencedirect.com/science/article/pii/S2589537019301853 |
| spellingShingle | Qiaosen Chen Ding Zeng Yangyang She Yuhan Lyu Xiao Gong Matthew J. Feinstein Yi Yang Hongbo Jiang Different transmission routes and the risk of advanced HIV disease: A systematic review and network meta-analysis of observational studies EClinicalMedicine |
| title | Different transmission routes and the risk of advanced HIV disease: A systematic review and network meta-analysis of observational studies |
| title_full | Different transmission routes and the risk of advanced HIV disease: A systematic review and network meta-analysis of observational studies |
| title_fullStr | Different transmission routes and the risk of advanced HIV disease: A systematic review and network meta-analysis of observational studies |
| title_full_unstemmed | Different transmission routes and the risk of advanced HIV disease: A systematic review and network meta-analysis of observational studies |
| title_short | Different transmission routes and the risk of advanced HIV disease: A systematic review and network meta-analysis of observational studies |
| title_sort | different transmission routes and the risk of advanced hiv disease a systematic review and network meta analysis of observational studies |
| url | http://www.sciencedirect.com/science/article/pii/S2589537019301853 |
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