HIV is a global pandemic with more than 37 million people living with HIV worldwide. Antiretroviral therapy (ART) has substantially improved the prognosis and treatment of patients living with HIV/AIDS. However, its use and implementation have some challenges.
The goal of this project is to investigate best practices and implementations of ART.
Because the HIV virus has a great variety of subtypes which can lead to sub-optimal treatment care. I investigated the trends of HIV subtypes in Sweden, and, by using the Swedish InfCare HIV database and a multinomial regression model, I found that HIV-subtypes in Sweden are very diverse. These findings can help understanding how HIV diversity affects HIV prevention, antiretroviral treatment, and vaccine development.
- Neogi, U., Häggblom, A., Santacatterina, M., et. al. Temporal Trends in the Swedish HIV-1 Epidemic: Increase in Non-B Subtypes and Recombinant Forms over Three Decades, PloS One, 2014
Because of the difficulty in resources-limited settings to sustain ART programs to prevent drug resistance and treatment failure, I investigated if peer support has an impact on virologic and immunologic treatment outcomes among HIV infected patients. To do so, I designed a randomized clinical trial and investigated if peer support has an effect on time to viral failure and death by using Kaplan-Meier curves and Cox regression models. In addition, I investigated if peer support has an effect on CD4 cell count trends over time by using mixed-effect models. From the results of these investigations, I found that peer support has no impact on virologic failure and CD4 trends as well as on mortality after 24 months of ART initiation.
Sönnerborg, A., Tam, V.V., El-Khatib, Z., Santacatterina, M., et. al., Impact of peer support on virologic failure in HIV-infected patients on antiretroviral therapy-a cluster randomized controlled trial in Vietnam, BMC infectious diseases, 2016
Cuong,D.D., Agneskog, E., Nguyen Thi Kim, C., Santacatterina, M., et.al. Monitoring the efficacy of antiretroviral therapy by a simple reverse transcriptase assay in HIV-infected adults in rural Vietnam, Future Medicine, 2012
To better understand the effect of treatment switch from first-line to second-line HIV treatment, I used the Swedish InfCare HIV database and a Laplace regression model to analyze the impact of patients’ reasons for treatment switch on the median, 10th, 20th, 30th and 40th percentile of time to viral failure after second-line switch. I found that there was no significant difference in time to second-line treatment failure between reasons for treatment switch. However, I found that the level of viral load at first-line ART failure had a significant impact on failure of second-line HIV treatment starting after 2.5 years of second-line treatment.
- Häggblom, A., Santacatterina, M., et. al. Effect of therapy switch on time to second-line antiretroviral treatment failure in HIV-infected patients, PloS One, 2017