Predictors of Viral Suppression and Rebound Among HIV-Positive Men Who Have Sex With Men in a Large Multi-Site Canadian Cohort

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dc.contributor.authorTanner, Zachary
dc.contributor.authorLachowsky, Nathan J.
dc.contributor.authorDing, Erin
dc.contributor.authorSamji, Hasina
dc.contributor.authorHull, Mark
dc.contributor.authorCescon, Angela
dc.contributor.authorPatterson, Sophie
dc.contributor.authorChia, Jason
dc.contributor.authorLeslie, Alia
dc.contributor.authorRaboud, Janet
dc.contributor.authorLoutfy, Mona
dc.contributor.authorCooper, Curtis
dc.contributor.authorKlein, Marina
dc.contributor.authorMachouf, Nima
dc.contributor.authorTsoukas, Christos
dc.contributor.authorMontaner, Julio
dc.contributor.authorHogg, Robert S.
dc.date.accessioned2022-06-16T23:43:51Z
dc.date.available2022-06-16T23:43:51Z
dc.date.copyright2016en_US
dc.date.issued2016
dc.descriptionWe would like to thank all of the participants for allowing their information to be a part of the CANOC collaboration.en_US
dc.description.abstractBackground: Gay, bisexual and other men who have sex with men (MSM) are disproportionately affected by HIV in Canada. Combination antiretroviral therapy has been shown to dramatically decrease progression to AIDS, premature death and HIV transmission. However, there are no comprehensive data regarding combination antiretroviral therapy outcomes among this population. We sought to identify socio-demographic and clinical correlates of viral suppression and rebound. Methods: Our analysis included MSM participants in the Canadian Observational Cohort, a multi-site cohort of HIV-positive adults from Canada's three most populous provinces, aged 2'.18 years who first initiated combination antiretroviral therapy between 2000 and 2011. We used accelerated failure time models to identify factors predicting time to suppression (2 measures <50 copies/ml 2'.30 days apart) and subsequent rebound (2 measures >200 copies/ml 2'.30 days apart). Results: Of 2,858 participants, 2,448 (86 %) achieved viral suppression in a median time of 5 months (Ql-Q3: 3-7 months). Viral suppression was significantly associated with later calendar year of antiretroviral therapy initiation, no history of injection drug use, lower baseline viral load, being on an initial regimen consisting of non-nucleoside reverse-transcriptase inhibitors, and older age. Among those who suppressed, 295 (12 %) experienced viral rebound. This was associated with earlier calendar year of antiretroviral therapy initiation, injection drug use history, younger age, higher baseline CD4 cell count, and living in British Columbia. Conclusions: Further strategies are required to optimize combination antiretroviral therapy outcomes in men who have sex with men in Canada, specifically targeting younger MSM and those with a history of injection drug use.en_US
dc.description.reviewstatusRevieweden_US
dc.description.scholarlevelFacultyen_US
dc.description.sponsorshipCANOC is funded by the Canadian Institutes of Health Research (CIHR) through a Centres Grant (Centres for HIV/AIDS Population Health and Health Services Research), two Operating Grants (HIV/AIDS Priority Announcement; Population and Public Health), and is also supported by the CIHR Canadian HIV Trials Network (CTN242). NJL is supported by a CANFAR/CTN Postdoctoral Fellowship Award. AC is supported through a CANOC Centre Scholar Award. CC is supported through an Applied HIV Research Chair from the OHTN. MBK is supported by a Chercheur-Boursier Clinicien Senior Career Award from the Fonds de recherche en sante du Quebec (FRSQ). MRL receives salary support from CIHR. JSGM is supported by an Avant-Garde Award from the National Institute on Drug Abuse, National Institutes of Health. SP is supported by a Study Abroad Studentship from the Leverhulme Trust. JR is supported through an OHTN Chair in Biostatistics. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The authors have no competing interests to declare.en_US
dc.identifier.citationTanner, Z., Lachowsky, N., Ding, E., Samji, H., Hull, M., Cescon, A., Patterson, S., Chia, J., Leslie, A., Raboud, J., Loutfy, M., Cooper, C., Klein, M., Machouf, N., Tsoukas, C., Montaner, J., & Hogg, R. S. for the Canadian Observation Cohort (CANOC) Collaboration. (2016). “Predictors of Viral Suppression and Rebound Among HIV-Positive Men Who Have Sex With Men in a Large Multi-Site Canadian Cohort.” BMC Infectious Diseases, 16(590), 1–11. https://doi.org/10.1186/s12879- 016-1926-zen_US
dc.identifier.urihttps://doi.org/10.1186/s12879-016-1926-z
dc.identifier.urihttp://hdl.handle.net/1828/13987
dc.language.isoenen_US
dc.publisherBMC Infectious Diseasesen_US
dc.subjectCanada
dc.subjectHIV
dc.subjectMSM
dc.subjectViral load
dc.subjectSuppression
dc.subjectRebound
dc.subjectCentre for Addictions Research of BC (CARBC)
dc.subjectCanadian Institute for Substance Use Research (CISUR)
dc.subject.departmentSchool of Public Health and Social Policy
dc.titlePredictors of Viral Suppression and Rebound Among HIV-Positive Men Who Have Sex With Men in a Large Multi-Site Canadian Cohorten_US
dc.typeArticleen_US

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