Different transmission routes and the risk of advanced HIV disease: A systematic review and network meta-analysis of observational studies
العنوان: | Different transmission routes and the risk of advanced HIV disease: A systematic review and network meta-analysis of observational studies |
---|---|
المؤلفون: | Yuhan Lyu, Matthew J. Feinstein, Yangyang She, Qiaosen Chen, Yi Yang, Ding Zeng, Xiao Gong, Hongbo Jiang |
المصدر: | EClinicalMedicine EClinicalMedicine, Vol 16, Iss, Pp 121-128 (2019) |
بيانات النشر: | Elsevier BV, 2019. |
سنة النشر: | 2019 |
مصطلحات موضوعية: | lcsh:R5-920, education.field_of_study, business.industry, 010102 general mathematics, Population, MEDLINE, General Medicine, Odds ratio, medicine.disease, 01 natural sciences, Men who have sex with men, 03 medical and health sciences, 0302 clinical medicine, Acquired immunodeficiency syndrome (AIDS), Environmental health, Meta-analysis, medicine, Observational study, 030212 general & internal medicine, 0101 mathematics, lcsh:Medicine (General), business, education, Research Paper, Sex work |
الوصف: | 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. |
تدمد: | 2589-5370 |
URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::306bcb15e936ed4f90432a4ebe2d877d https://doi.org/10.1016/j.eclinm.2019.10.003 |
حقوق: | OPEN |
رقم الأكسشن: | edsair.doi.dedup.....306bcb15e936ed4f90432a4ebe2d877d |
قاعدة البيانات: | OpenAIRE |
تدمد: | 25895370 |
---|