Evidence map›Paper›PMID 18090394›Full record

Trial reportAIDS (London, England)2008

Differential adherence to combination antiretroviral therapy is associated with virological failure with resistance.

Edward M Gardner, Shweta Sharma, Grace Peng, Katherine Huppler Hullsiek, William J Burman, Rodger D Macarthur, Margaret Chesney, Edward E Telzak, Gerald Friedland, Sharon B Mannheimer

Abstract readComparative StudyRandomized Controlled Trial
In one paragraph

Trial report in AIDS (London, England), 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 61 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
61citing papers in PubMed, 2 pooled it
6.6field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

61 citing papers in PubMed, 2 syntheses or guidelines pooled it, 124 citations in OpenAlex.

  1. Guideline
  2. Better adherence with once-daily antiretroviral regimens: a meta-analysis.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2009
    Pooled it
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  18. Electronic Dose Monitoring Identifies a High-Risk Subpopulation in the Treatment of Drug-resistant Tuberculosis and Human Immunodeficiency Virus.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021
    Article
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1 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 7 institutions in 1 country.

Edward M GardnerDenver Public Health, Denver, Colorado 80204, USA. edward.gardner@dhha.org
Shweta Sharma
Grace Peng
Katherine Huppler Hullsiek
William J Burman
Rodger D Macarthur
Margaret Chesney
Edward E Telzak
Gerald Friedland
Sharon B Mannheimer
University of Minnesota · USBronx-Lebanon Hospital Center · USDenver Public Health · USGTx (United States) · USNational Center for Complementary and Integrative Health · USWayne State University · USYale University · US

Funding

International Network for Strategic Initiatives in Global HIV Trials (INSIGHT)U01AI068641 · NIAID · UNIVERSITY OF MINNESOTA · PI NEATON, JAMES DENNIS · 2006 to 2010
$120.1M
COMMUNITY PROGRAMS FOR CLINICAL RESEARCH ON AIDSU01AI046362 · NIAID · SOCIAL AND SCIENTIFIC SYSTEMS, INC. · PI GORDIN, FRED M · 2000 to 2006
$75.9M
TERRY BEIRN COMMUNITY PROGRAMS FOR CLINICAL RESEARCH ONU01AI042170 · NIAID · UNIVERSITY OF MINNESOTA TWIN CITIES · PI NEATON, JAMES DENNIS · 1997 to 2006
$23.2M
Patterns of antiretroviral nonadherence: association with outcomes & cost careK01AI067063 · NIAID · DENVER HEALTH AND HOSPITAL AUTHORITY · PI GARDNER, EDWARD M · 2005 to 2009
$657k
NIAID NIH HHS 1U01AI068641NIAID NIH HHS 5U01AI042170NIAID NIH HHS 5U01AI046362NIAID NIH HHS K01 AI067063NIAID NIH HHS U01 AI042170NIAID NIH HHS U01 AI046362NIAID NIH HHS U01 AI068641
6 · The paper itself

Abstract

objectivesTo investigate the occurrence of differential adherence to components of combination antiretroviral therapy and assess its predictors and association with virological failure and antiretroviral medication resistance.

designA secondary analysis of prospective clinical trial data.

methodsThe Flexible Initial Retrovirus Suppressive Therapies study (Community Programs for Clinical Research on AIDS 058) was a randomized trial comparing non-nucleoside reverse transcriptase inhibitor (NNRTI) versus protease inhibitor (PI) versus NNRTI plus PI-based (three-class) antiretroviral therapy in treatment-naive HIV-1-infected individuals. Adherence was assessed at months 1 and 4, and then every 4 months. Differential adherence, defined as any difference in self-reported level of adherence to individual antiretroviral medications at the same timepoint, was evaluated as a binary time-updated variable in multivariate Cox regression analyses of time to initial virological failure (HIV-RNA > 1000 copies/ml) and initial virological failure with genotypic antiretroviral resistance.

resultsDifferential adherence was reported at least once by 403 of 1379 participants (29%), over 60 months median follow-up. Differential adherence was more commonly reported by participants randomly assigned to the three-class strategy (35%) than the NNRTI (28%) or PI (25%) strategies (P = 0.005), but was not associated with demographic or baseline disease-specific factors. Of those reporting differential adherence, 146 (36%) reported it before initial virological failure. These participants had an increased risk of initial virological failure and initial virological failure with antiretroviral resistance compared with participants without differential adherence before initial virological failure.

conclusionDifferential adherence was commonly reported and was associated with an increased risk of initial virological failure and initial virological failure with antiretroviral resistance.

Indexed as

HIV-1Antiretroviral Therapy, Highly ActiveDrug Resistance, ViralHIV InfectionsHIV Protease InhibitorsHumansPatient ComplianceProspective StudiesReverse Transcriptase InhibitorsTreatment OutcomeViral LoadHIV Protease InhibitorsReverse Transcriptase Inhibitors

Identifiers

PMID18090394
PMCPMC2405889
OpenAlexW2034425909

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.