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Reaching the Second and Third Joint United Nations Programme on Human Immunodeficiency Virus (HIV)/AIDS 90-90-90 Targets Is Accompanied by a Dramatic Reduction in Primary HIV Infection and in Recent HIV Infections in a Large French Nationwide HIV Cohort

2019; Oxford University Press; Volume: 71; Issue: 2 Linguagem: Inglês

10.1093/cid/ciz800

1537-6591

Adrien Le Guillou, Pascal Puglièse, F. Raffi, André Cabie, Lise Cuzin, Christine Katlama, Clotilde Allavena, Moustapha Dramé, Laurent Cotte, Firouzé Bani‐Sadr, M Orticoni, M J Soavi, I Besson, E Ressiot, Marianna Padovani, M J Ducassou, H Bertone, S Galie, Anne Galinier, M Monclar, A S Ritleng, A Ivanova, Carla Blanco-Betancourt, C Lions, Isabelle Poizot‐Martin, C Dhiver, Malika Mokhtarı, A Ménard, H Tissot Dupont, C Toméi, Line Meddeb, A Y Belkhir, I Ravaux, Marco Antonio Álvarez, N Biezunski, A Debard, Cyrille Delpierre, P Lansalot, L Lelièvre, Guillaume Martin‐Blondel, M Piffaut, Lorena Porte, Karine Sauné, Pierre Delobel, Pascal Puglièse, S Bréaud, C Ceppi, D Chirio, E Cua, P. Dellamonica, E Demonchy, Anne De Monte, J Durant, C Etienne, Stephen J. Ferrando, R. Garraffo, C Michelangeli, V. Mondain, C Allavena, C Bernaud, E Billaud, Charlotte Biron, B. Bonnet, Sabelline Bouchez, David Boutoille, Cécile Brunet-Cartier, Colin Deschanvres, Benjamin Gaborit, Nolwenn Hall, T Jovelin, Paul Le Turnier, P Morineau, Véronique Reliquet, S Sécher, M Cavellec, A Soria, Virginie Ferré, Elisabeth André‐Garnier, A Rodallec, M. Lefèbvre, Olivier Grossi, O Aubry, F. Raffi, Karima Amazzough, Ghania Benabdelmoumen, P Bossi, G Cessot, C Charlier, Paul‐Henri Consigny, François Danion, Amélie Duréault, C Duvivier, Julia Goesch, R Guery, B Henry, Kaoutar Jidar, Fanny Lanternier, Paul Loubet, O Lortholary, C Louisin, J Lourenco, P Parize, B Pilmis, F. Touam, M. A. Valantin, R Tubiana, R Agher, Sophie Seang, L Schneider, Romain Palich, C Blanc, Christine Katlama, André Cabie, L Cuzin, Sylvie Abel, S. Pierre-François, J Pasquier, K Guitteaud, J M Turmel, Marina Illiaquer, Patricia Fischer, M Partisani, C Cheneau, M. Priester, M.-L. Batard, Claudine Bernard-Henry, E de Mautort, Samira Fafi‐Kremer, Diego Rey, C Chirouze, Quentin Gardiennet, F Bani-Sadr, J L Berger, Yohan N’Guyen, D Lambert, Maxime Hentzien, D. Lebrun, A Brunet, I Kmiec, V Brodard, Laurent Cotte, Christian Chidiac, Tristan Ferry, Florence Ader, F. Biron, A Boibieux, Patrick Miailhes, T Perpoint, I Schlienger, John Lippmann, E Braun, J. Koffi, C Longuet, V. Guéripel, C Augustin-Normand, Céline Brochier‐Armanet, S Degroodt, N. Atoui, Vincent Le Moing, Alain Makinson, N Meftah, Corinne Merle De Boever, B Montes, A Montoya Ferrer, Jacques Reynes, Marie André, L Boyer, M P Bouillon, M Delestan, T. May, Laurent Hocqueloux, Thiérry Prazuck, C. Gubavu, A Sève, A Maka, C. Boulard, G Thomas, Arnaud Chéret, C Goujard, Yann Quertainmont, Elina Teicher, N Lerolle, O Deradji, Aurélie Barrail‐Tran, Roland Landman, Véronique Joly, C. Rioux, Sylvie Lariven, A. Gervais, François‐Xavier Lescure, Sophie Matheron, F Louni, C Godard, Zélie Julia, M. Chansombat, Djamila Rahli, C Mackoumbou-Nkouka, C. Charpentier, Diane Descamps, G Peytavin, Yazdan Yazdanpanah, P Tattevin, M Revest, Faouzi Souala, M Baldeyrou, S. Patrat-Delon, J.-M. Chapplain, François Bénézit, Magali Dupont, M Poinot, A Maillard, C Pronier, F. Lemaı̂tre, S Patrat-Delon, M Poisson-Vanier, T Jovelin, J P Sinteff, C. Arvieux, Élisabeth Botelho-Nevers, Amandine Gagneux‐Brunon, A. Frésard, F. Lucht, F. Ajana, E. Aïssi, I Alcaraz, V Baclet, Laurence Bocket, Anne Boucher, P Choisy, T. Huleux, B. Lafon-Desmurs, Agnès Meybeck, M Pradier, O Robineau, N Viget, M Valette, Bruno Hoën, I. Lamaury, Isabelle Fabre, Elodie Curlier, Rachida Ouissa, Kinda Schepers, Cécile Herrmann‐Storck, Nathalie Dournon, D Merrien, P Perré, T Guimard, O Bollangier, S Léautez, M Morrier,

HIV/AIDS drug development and treatment

Abstract Background In late 2013, France was one of the first countries to recommend initiation of combination antiretroviral therapy (cART) irrespective of CD4 cell count. Methods To assess the impact of achieving the second and third Joint United Nations Programme on HIV/AIDS 90-90-90 targets (ie, 90% of diagnosed people on sustained cART, and, of those, 90% virologically controlled) on human immunodeficiency virus (HIV) incidence, we conducted a longitudinal study to describe the epidemiology of primary HIV infection (PHI) and/or recent HIV infection (patients with CD4 cell count ≥500/mm3 at HIV diagnosis; (PRHI) between 2007 and 2017 in a large French multicenter cohort. To identify changes in trends in PHI and PRHI, we used single breakpoint linear segmented regression analysis. Results During the study period, 61 822 patients were followed in the Dat’AIDS cohort; 2027 (10.0%) had PHI and 7314 (36.1%) had PRHI. The second and third targets were reached in 2014 and 2013, respectively. The median delay between HIV diagnosis and cART initiation decreased from 9.07 (interquartile range [IQR], 1.39–33.47) months in 2007 to 0.77 (IQR, 0.37–1.60) months in 2017. A decrease in PHI (−35.1%) and PRHI (−25.4%) was observed starting in 2013. The breakpoints for PHI and PRHI were 2012.6 (95% confidence interval [CI], 2010.8–2014.4) and 2013.1 (95% CI, 2011.3–2014.8), respectively. Conclusions Our findings show that the achievements of 2 public health targets in France and the early initiation of cART were accompanied by a reduction of about one-third in PHI and PRHI between 2013 and 2017. Clinical Trials Registration NCT02898987.