The HIV Outpatient Study—25 Years of HIV Patient Care and Epidemiologic Research

Abstract Background The clinical epidemiology of treated HIV infection in the United States has dramatically changed in the past 25 years. Few sources of longitudinal data exist for people with HIV (PWH) spanning that period. Cohort data enable investigating new exposure and disease associations and...

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Bibliographic Details
Published in:Open forum infectious diseases 2020-05, Vol.7 (5), p.ofaa123
Main Authors: Buchacz, Kate, Armon, Carl, Palella, Frank J, Novak, Richard M, Fuhrer, Jack, Tedaldi, Ellen, Ward, Douglas, Mayer, Cynthia, Battalora, Linda, Carlson, Kimberly, Purinton, Stacey, Durham, Marcus, Li, Jun
Format: Article
Language:English
Subjects:
AIDS treatment
Analysis
Antiviral agents
Chronic diseases
Epidemiology
Health aspects
Highly active antiretroviral therapy
HIV (Viruses)
HIV infection
HIV patients
Infection
Information management
Medical research
Medicine, Experimental
Review
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Summary:Abstract Background The clinical epidemiology of treated HIV infection in the United States has dramatically changed in the past 25 years. Few sources of longitudinal data exist for people with HIV (PWH) spanning that period. Cohort data enable investigating new exposure and disease associations and monitoring progress along the HIV care continuum. Methods We synthesized key published findings and conducted primary data analyses in the HIV Outpatient Study (HOPS), an open cohort of PWH seen at public and private HIV clinics since 1993. We assessed temporal trends in health outcomes (1993–2017) and mortality (1994–2017) for 10 566 HOPS participants. Results The HOPS contributed to characterizing new conditions (eg, lipodystrophy), demonstrated reduced mortality with earlier HIV treatment, uncovered associations between select antiretroviral agents and cardiovascular disease, and documented remarkable shifts in morbidity from AIDS opportunistic infections to chronic noncommunicable diseases. The median CD4 cell count of participants increased from 244 cells/mm3 to 640 cells/mm3 from 1993 to 2017. Mortality fell from 121 to 16 per 1000 person-years from 1994 to 2017 (P 
ISSN:2328-8957
2328-8957
DOI:10.1093/ofid/ofaa123