The impact of HIV research on health outcome and healthcare policy.

Human immunodeficiency virus (HIV) infection and the acquired immunodeficiency syndrome (AIDS) have shown an almost unique linkage between biomedical research and improved healthcare outcomes. A transformation has been seen between 1981 when AIDS was a rapidly fatal condition, to the present dramatic survival prolongation. HIV infection is a chronic illness requiring ongoing modern therapy. Parallels and interactions between HIV research and cancer research are close. The ability of novel therapies to suppress HIV replication and restore host immunity has decreased the incidence and progression of cancers in HIV patients. The rapid application of new knowledge to patient care and health policy in HIV has key lessons for other disease areas. Patient and Public Involvement has been influential in research activity and funding. The availability of laboratory markers of disease has been central to the successful application of novel HIV therapies. Active development and management of cooperative large-scale clinical trials supported by advocacy groups was influential. HIV investigators have been at the forefront of identifying cost-effective treatments that can be widely applied. The science, clinical research and political response to the HIV epidemic offer a model generalizable to other serious diseases. Opportunities to share the experiences and lessons learned from HIV should be sought, particularly in the cancer research community.

[1]  David V Glidden,et al.  Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. , 2010, The New England journal of medicine.

[2]  R. Pfeiffer,et al.  Age at Cancer Diagnosis Among Persons With AIDS in the United States , 2010, Annals of Internal Medicine.

[3]  P. Volberding,et al.  HIV and Premature Aging: A Field Still in Its Infancy , 2010, Annals of Internal Medicine.

[4]  P. Volberding,et al.  Antiretroviral therapy and management of HIV infection , 2010, The Lancet.

[5]  Connie Celum,et al.  Heterosexual HIV-1 transmission after initiation of antiretroviral therapy: a prospective cohort analysis , 2010, The Lancet.

[6]  Michael J Silverberg,et al.  Effect of early versus deferred antiretroviral therapy for HIV on survival. , 2009, The New England journal of medicine.

[7]  Ross J. Harris,et al.  Mortality of HIV-infected patients starting potent antiretroviral therapy: comparison with the general population in nine industrialized countries. , 2009, International journal of epidemiology.

[8]  A. Sasco,et al.  Role of uncontrolled HIV RNA level and immunodeficiency in the occurrence of malignancy in HIV-infected patients during the combination antiretroviral therapy era: Agence Nationale de Recherche sur le Sida (ANRS) CO3 Aquitaine Cohort. , 2009, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[9]  A. Justice,et al.  Incidence of Non-AIDS-Defining Malignancies in HIV-Infected Versus Noninfected Patients in the HAART Era: Impact of Immunosuppression , 2009, Journal of acquired immune deficiency syndromes.

[10]  A. Mocroft,et al.  Prognosis of HIV-associated non-Hodgkin lymphoma in patients starting combination antiretroviral therapy , 2009, AIDS.

[11]  Adriano Lazzarin,et al.  Safety and efficacy of raltegravir-based versus efavirenz-based combination therapy in treatment-naive patients with HIV-1 infection: a multicentre, double-blind randomised controlled trial , 2009, The Lancet.

[12]  B. Gazzard,et al.  The effect of HAART in 254 consecutive patients with AIDS-related Kaposi's sarcoma , 2009, AIDS.

[13]  S. Cole,et al.  The Association of HIV Susceptibility Testing With Survival Among HIV-Infected Patients Receiving Antiretroviral Therapy: A Cohort Study , 2009, Annals of Internal Medicine.

[14]  B. Ledergerber,et al.  Timing of initiation of antiretroviral therapy in AIDS-free HIV-1-infected patients: a collaborative analysis of 18 HIV cohort studies , 2009, The Lancet.

[15]  B. Gazzard,et al.  Efficacy and safety of entecavir for chronic HBV in HIV/HBV coinfected patients receiving lamivudine as part of antiretroviral therapy , 2008, AIDS.

[16]  J. Lundgren Use of nucleoside reverse transcriptase inhibitors and risk of myocardial infarction in HIV-infected patients , 2008, AIDS.

[17]  S. Cole,et al.  Effect of HAART on Incident Cancer and Noncancer AIDS Events Among Male HIV Seroconverters , 2008, Journal of acquired immune deficiency syndromes.

[18]  S. Hammer,et al.  Antiretroviral drug resistance testing in adult HIV-1 infection: 2008 recommendations of an International AIDS Society-USA panel. , 2008, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[19]  M. Falster,et al.  Incidence of cancers in people with HIV/AIDS compared with immunosuppressed transplant recipients: a meta-analysis , 2007, The Lancet.

[20]  Richard D Moore,et al.  An Improvement in Virologic Response to Highly Active Antiretroviral Therapy in Clinical Practice From 1996 Through 2002 , 2005, Journal of acquired immune deficiency syndromes.

[21]  Joel E Gallant,et al.  Efficacy and safety of tenofovir DF vs stavudine in combination therapy in antiretroviral-naive patients: a 3-year randomized trial. , 2004, JAMA.

[22]  M C Weinstein,et al.  The cost effectiveness of combination antiretroviral therapy for HIV disease. , 2001, The New England journal of medicine.

[23]  M. Elashoff,et al.  The use of plasma HIV RNA as a study endpoint in efficacy trials of antiretroviral drugs. , 1999, AIDS.

[24]  JD Lundgren,et al.  Changing patterns of mortality across Europe in patients infected with HIV-1 , 1998, The Lancet.

[25]  G. Satten,et al.  Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection. HIV Outpatient Study Investigators. , 1998, The New England journal of medicine.

[26]  P. Lurie,et al.  Unethical trials of interventions to reduce perinatal transmission of the human immunodeficiency virus in developing countries. , 1997, The New England journal of medicine.

[27]  M A Fischl,et al.  A controlled trial of two nucleoside analogues plus indinavir in persons with human immunodeficiency virus infection and CD4 cell counts of 200 per cubic millimeter or less. AIDS Clinical Trials Group 320 Study Team. , 1997, The New England journal of medicine.

[28]  Roger Detels,et al.  Plasma Viral Load and CD4+ Lymphocytes as Prognostic Markers of HIV-1 Infection , 1997, Annals of Internal Medicine.

[29]  Amalio Telenti,et al.  Antiretroviral Treatment of Adult HIV Infection2010 Recommendations of the International AIDS Society–USA Panel , 2010 .

[30]  S. Cole,et al.  American Journal of Epidemiology Practice of Epidemiology Using Marginal Structural Measurement-error Models to Estimate the Long-term Effect of Antiretroviral Therapy on Incident Aids or Death , 2022 .