National characteristics and trends in antiretroviral treatment in Australia can be accurately estimated using a large clinical cohort

Robin Huang, Kathy Petoumenos*, Richard T. Gray, Hamish McManus, Nila Dharan, Rebecca Guy, David A. Cooper

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)


Objectives: Cohort studies are often used as a national surveillance tool to monitor trends in HIV treatment and morbidity outcomes. However, there are limited studies validating the accuracy of using cohorts as a representation of the overall HIV-positive population. We compared data from a large Australian HIV-positive cohort study (Australian HIV Observational Database [AHOD]) and a 10% longitudinal sample from Australia's subsidized prescription medication scheme (Pharmaceutical Benefits Scheme [PBS]) to assess the use of cohorts for providing representative data for surveillance and monitoring purposes. Study Design and Setting: Basic demographics and treatment information from July 1, 2013, to March 31, 2016, were divided into half-yearly periods to compare HIV trends between AHOD (n = 2,488) and PBS (n = 18,409) patients. Results: In both data sets, most patients were men, aged above 50 years, and primarily resided in New South Wales. Both data sets revealed a significant shift toward the increased use of integrase strand transfer inhibitors and a gradual decline in the use of protease inhibitors and nonnucleoside reverse-transcriptase inhibitors among the treated population in Australia. Similarly, a substantial increase in the use of once daily, single-tablet, fixed-dose combination regimens was also observed. Conclusion: Our results show that observational cohort studies can serve as useful surrogate surveillance tools for monitoring patient characteristics and HIV treatment trends.

Original languageEnglish
Pages (from-to)82-91
Number of pages10
JournalJournal of Clinical Epidemiology
Publication statusPublished - Aug 2018
Externally publishedYes

Bibliographical note

Funding Information:
The Australian HIV Observational Database is funded as part of the Asia Pacific HIV Observational Database, a program of amfAR, The Foundation for AIDS Research, and is supported in part by grant no. U01AI069907 from the US National Institutes of Health's National Institute of Allergy and Infectious Diseases, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the National Cancer Institute, the National Institute of Mental Health, and the National Institute on Drug Abuse and by unconditional grants from Merck Sharp & Dohme, Gilead Sciences,Janssen-Cilag, and ViiV Healthcare. The Kirby Institute is funded by the Australian Government Department of Health and is affiliated with the Faculty of Medicine, UNSW Australia. The content is solely the responsibility of the authors, and the views expressed in this publication do not necessarily represent the position of the Australian Government or the official views of the US National Institutes of Health or other funders.

Publisher Copyright:
© 2018 Elsevier Inc.


  • Antiretroviral treatment
  • Cohort
  • HIV infection
  • Observational data
  • Surveillance
  • Treatment monitoring


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