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Cohort profile: Development and profile of a population-based, retrospective cohort of diagnosed people living with HIV in Ontario, Canada (Ontario HIV Laboratory Cohort)

Authors: Liu, Juan; Wilton, James; Sullivan, Ashleigh; Marchand-Austin, Alex; Rachlis, Beth; Giles, Madison; Light, Lucia; +3 Authors

Cohort profile: Development and profile of a population-based, retrospective cohort of diagnosed people living with HIV in Ontario, Canada (Ontario HIV Laboratory Cohort)

Abstract

PurposePopulation-based cohorts of diagnosed people living with HIV (PLWH) are limited worldwide. In Ontario, linked HIV diagnostic and viral load (VL) test databases are centralised and contain laboratory data commonly used to measure engagement in HIV care. We used these linked databases to create a population-based, retrospective cohort of diagnosed PLWH in Ontario, Canada.ParticipantsA datamart was created by integrating diagnostic and VL databases and linking records at the individual level. These databases contain information on laboratory test results and sociodemographic/clinical information collected on requisition/surveillance forms. Datamart individuals enter our cohort with the first record of a nominal HIV-positive diagnostic test (1985–2015) or VL test (1996–2015), and remain unless administratively lost to follow-up (LTFU; no VL test for >2 years and no VL test in later years). Non-nominal diagnostic tests are excluded as they lack identifying information to permit linkage to other tests. However, individuals diagnosed non-nominally are included in the cohort with record of a VL test. The LTFU rule is applied to indirectly censor for death/out-migration.Findings to dateAs of the end of 2015, the datamart contained 40 372 HIV-positive diagnostic tests and 23 851 individuals with ≥1 VL test. Almost half (46.3%) of the diagnostic tests were non-nominal and excluded, although this was lower (~15%) in recent years. Overall, 29 587 individuals have entered the cohort—contributing 229 302 person-years of follow-up since 1996. Between 2000 and 2015, the number of diagnosed PLWH (cohort individuals not LTFU) increased from 8859 to 16 110, and the percent who were aged ≥45 years increased from 29.1% to 62.6%. The percent of diagnosed PLWH who were virally suppressed (<200 copies/mL) increased from 40.7% in 2000 to 79.5% in 2015.Future plansWe plan to conduct further analyses of HIV care engagement and link to administrative databases with information on death, migration, physician billing claims and prescriptions. Linkage to other data sources will address cohort limitations and expand research opportunities.

Subjects by Vocabulary

Microsoft Academic Graph classification: medicine.medical_specialty Population Acquired immunodeficiency syndrome (AIDS) Health care Medicine Medical prescription education education.field_of_study business.industry Retrospective cohort study medicine.disease Test (assessment) Family medicine Cohort business Viral load

Keywords

Adult, Male, Databases, Factual, 1842, retrospective cohort, HIV Infections, Cohort Studies, Young Adult, Age Distribution, administrative data, Humans, 1506, Sex Distribution, data linkage, Aged, Retrospective Studies, Ontario, Cohort Profile, healthcare, General Medicine, Middle Aged, Viral Load, population-based, Socioeconomic Factors, HIV/AIDS, Female

48 references, page 1 of 5

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2. Croxford S, Kitching A, Desai S, et al. Mortality and causes of death in people diagnosed with HIV in the era of highly active antiretroviral therapy compared with the general population: an analysis of a national observational cohort. Lancet Public Health 2017;2:e35-46.

3. Poorolajal J, Hooshmand E, Mahjub H, et al. Survival rate of AIDS disease and mortality in HIV-infected patients: a meta-analysis. Public Health 2016;139:3-12.

4. Patterson S, Cescon A, Samji H, et al. Life expectancy of HIVpositive individuals on combination antiretroviral therapy in Canada. BMC Infect Dis 2015;15:274.

5. Pharris A, Quinten C, Tavoschi L, et al. Trends in HIV surveillance data in the EU/EEA, 2005 to 2014: new HIV diagnoses still increasing in men who have sex with men. Euro Surveill 2015;20:30071. [OpenAIRE]

6. Centre for Disease Control. HIV surveillance report. 2016 https:// www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hivsurveillance-report-2016-vol-28.pdf (accessed 6 Dec 2017).

7. Bourgeois AC, Edmunds M, Awan A, et al. HIV in CanadaSurveillance Report, 2016. Can Commun Dis Rep 2017;43:248-56.

8. Samji H, Cescon A, Hogg RS, et al. Closing the gap: increases in life expectancy among treated HIV-positive individuals in the United States and Canada. PLoS One 2013;8:e81355.

9. May M, Gompels M, Delpech V, et al. Impact of late diagnosis and treatment on life expectancy in people with HIV-1: UK Collaborative HIV Cohort (UK CHIC) Study. BMJ 2011;343:d6016. [OpenAIRE]

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citations
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
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