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

37 Scopus citations

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

Keywords

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

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases

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    Silverberg, M. J., Wegner, S. A., Milazzo, M. J., McKaig, R. G., Williams, C. F., Agan, B. K., Armstrong, A. W., Gange, S. J., Hawkes, C., O'Connell, R. J., Ahuja, S. 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