Evidence map›Paper›PMID 19282780›Full record

ArticleJournal of acquired immune deficiency syndromes (1999)2009

Antiretroviral therapy adherence, virologic and immunologic outcomes in adolescents compared with adults in southern Africa.

Jean B Nachega, Michael Hislop, Hoang Nguyen, David W Dowdy, Richard E Chaisson, Leon Regensberg, Mark Cotton, Gary Maartens

Registry-linked trialOpen access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of acquired immune deficiency syndromes (1999), 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03848728 (Strategic Antiretroviral Therapy and HIV Testing for Youth in Rural Africa), which is not on this map. Cited by 280 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
280citing papers in PubMed, 7 pooled it
6.5field-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.

NCT03848728 nacompletednot on this mapstarted 2019, after this paper: background citation

Strategic Antiretroviral Therapy and HIV Testing for Youth in Rural Africa

TypeinterventionalSponsorUniversity of California, San FranciscoRan2019 to 2023Enrolled1,988ConditionsHIVArmsSEARCH Youth combination intervention
3 · Its place in the literature

Who cites it

280 citing papers in PubMed, 7 syntheses or guidelines pooled it, 452 citations in OpenAlex.

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  18. HIV Care Cascade Among Adolescents in a "Test and Treat" Community-Based Intervention: HPTN 071 (PopART) for Youth Study.The Journal of adolescent health : official publication of the Society for Adolescent Medicine · 2021
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220 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

8 authors at 2 institutions in 2 countries.

Jean B NachegaDepartment of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. jnachega@jhsph.edu
Michael Hislop
Hoang Nguyen
David W Dowdy
Richard E Chaisson
Leon Regensberg
Mark Cotton
Gary Maartens
Johns Hopkins University · USUniversity of Cape Town · ZA

Funding

MEDICAL SCIENTIST TRAINING PROGRAMT32GM007309 · NIGMS · JOHNS HOPKINS UNIVERSITY · PI COX, ANDREA L · 1985 to 2019
$43.2M
UNDERLYING MECHANISMS OF SCHISTOSOME/SNAIL COMPATIBILITYR01AI016137 · NIAID · OREGON STATE UNIVERSITY · PI BAYNE, CHRISTOPHER JEFFREY · 1989 to 2012
$3.1M
DOT-HAART for HIV-Infected South African AdultsR01AI055359 · NIAID · JOHNS HOPKINS UNIVERSITY · PI CHAISSON, RICHARD E. · 2003 to 2008
$2.6M
DOT-HARRT for HIV-Infected South African AdultsK23AI068582 · NIAID · JOHNS HOPKINS UNIVERSITY · PI NACHEGA, JEAN BISIMWA · 2006 to 2010
$652k
Underlying mechanisms of schistosome/snail compatibilityR21AI016137 · NIAID · OREGON STATE UNIVERSITY · PI BAYNE, CHRISTOPHER JEFFREY · 2001 to 2001
$273k
SCHISTOSOME-SNAIL COMPATIBILITY: UNDERLYING MECHANISMSR22AI016137 · NIAID · OREGON STATE UNIVERSITY · PI BAYNE, CHRISTOPHER JEFFREY · 1985 to 1991
–
NIAID NIH HHS AI 016137NIAID NIH HHS AI 5535901NIAID NIH HHS K23 AI068582NIAID NIH HHS K23 AI68582-01NIAID NIH HHS R01 AI016137NIAID NIH HHS R21 AI016137NIGMS NIH HHS 5 T32 GM07309NIGMS NIH HHS T32 GM007309
6 · The paper itself

Abstract

objectiveTo determine adherence to and effectiveness of antiretroviral therapy (ART) in adolescents vs. adults in southern Africa.

designObservational cohort study.

settingAid for AIDS, a private sector disease management program in southern Africa. SUBJECTS: Adolescents (age 11-19 years; n = 154) and adults (n = 7622) initiating ART between 1999 and 2006 and having a viral load measurement within 1 year after ART initiation.

main outcome measuresPrimary: virologic suppression (HIV viral load < or = 400 copies/mL), viral rebound, and CD4 T-cell count at 6, 12, 18, and 24 months after ART initiation. Secondary: adherence assessed by pharmacy refills at 6, 12, and 24 months. Multivariate analyses: loglinear regression and Cox proportional hazards.

resultsA significantly smaller proportion of adolescents achieved 100% adherence at each time point (adolescents: 20.7% at 6 months, 14.3% at 12 months, and 6.6% at 24 months; adults: 40.5%, 27.9%, and 20.6% at each time point, respectively; P < 0.01). Patients achieving 100% 12-month adherence were significantly more likely to exhibit virologic suppression at 12 months, regardless of age. However, adolescents achieving virologic suppression had significantly shorter time to viral rebound (adjusted hazard ratio 2.03; 95% confidence interval: 1.31 to 3.13; P < 0.003). Adolescents were less likely to experience long-term immunologic recovery despite initial CD4 T-cell counts comparable to adults.

conclusionsCompared with adults, adolescents in southern Africa are less adherent to ART and have lower rates of virologic suppression and immunologic recovery and a higher rate of virologic rebound after initial suppression. Studies must determine specific barriers to adherence in this population and develop appropriate interventions.

Indexed as

HIV-1AdolescentAdultAfrica, SouthernAge FactorsAnti-HIV AgentsCD4 Lymphocyte CountChildCohort StudiesFemaleHIV InfectionsHumansMalePatient CompliancePsychology, AdolescentYoung AdultAnti-HIV Agents

Identifiers

PMID19282780
PMCPMC2674125
OpenAlexW1974951626

What OpenQuestion holds

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Registered trials

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.