ArticleJournal of acquired immune deficiency syndromes (1999)2010
Mortality associated with discordant responses to antiretroviral therapy in resource-constrained settings.
Article in Journal of acquired immune deficiency syndromes (1999), 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 2 of them syntheses that pooled it.
What it found
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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.
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Who cites it
23 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Discordant Immune Response with Antiretroviral Therapy in HIV-1: A Systematic Review of Clinical Outcomes.PloS one · 2016Pooled it
- Rates of emergence of HIV drug resistance in resource-limited settings: a systematic review.Antiviral therapy · 2013Pooled it
- Reactivation of herpes simplex virus type 2 after initiation of antiretroviral therapy.The Journal of infectious diseases · 2013Trial
- Frequent detection of HPV before and after initiation of antiretroviral therapy among HIV/HSV-2 co-infected women in Uganda.PloS one · 2013Trial
- How to properly define immunological nonresponse to antiretroviral therapy in people living with HIV? an integrative review.Frontiers in immunology · 2025Review
- Clinical effects of durability of immunosuppression in virologically suppressed ART-initiating persons with HIV in Latin America. A retrospective cohort study.Lancet regional health. Americas · 2022Article
- Virological suppression and clinical management in response to viremia in South African HIV treatment program: A multicenter cohort study.PLoS medicine · 2020Article
- Southern African HIV Clinicians Society guidelines for antiretroviral therapy in adults: 2020 update.Southern African journal of HIV medicine · 2020Article
- Is it Safe and Cost Saving to Defer the CD4+ Cell Count Monitoring in Stable Patients on Art with More than 350 or 500 cells/μl?Mediterranean journal of hematology and infectious diseases · 2019Article
- Immunologic Effects of Maraviroc in HIV-Infected Patients with Severe CD4 Lymphopenia Starting Antiretroviral Therapy: A Sub-Study of the CADIRIS Trial.Pathogens & immunity · 2017Article
- Adult antiretroviral therapy guidelines 2017.Southern African journal of HIV medicine · 2017Article
- Choice of first-line antiretroviral therapy regimen and treatment outcomes for HIV in a middle income compared to a high income country: a cohort study.BMC infectious diseases · 2016Article
- Discordant Treatment Responses to Combination Antiretroviral Therapy in Rwanda: A Prospective Cohort Study.PloS one · 2016Article
- Is CD4 monitoring needed among ugandan clients achieving a virologic and immunologic response to treatment?AIDS patient care and STDs · 2014Article
- Characteristics and outcomes among older HIV-positive adults enrolled in HIV programs in four sub-Saharan African countries.PloS one · 2014Article
- Impact of HIV drug resistance on virologic and immunologic failure and mortality in a cohort of patients on antiretroviral therapy in China.AIDS (London, England) · 2013Article
- Performance of immunological response in predicting virological failure.AIDS research and human retroviruses · 2013Article
- Tenofovir in second-line ART in Zambia and South Africa: collaborative analysis of cohort studies.Journal of acquired immune deficiency syndromes (1999) · 2012Article
- Development and validation of systems for rational use of viral load testing in adults receiving first-line ART in sub-Saharan Africa.AIDS (London, England) · 2011Article
- A missing piece in the puzzle: HIV in mature adults in sub-Saharan Africa.Future virology · 2011Article
Corrections and comments
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Authors and funding
16 authors.
Funding
Abstract
objectivesWe assessed mortality associated with immunologic and virologic patterns of response at 6 months of highly active antiretroviral therapy (HAART) in HIV-infected individuals from resource-limited countries in Africa and South America.
methodsPatients who initiated HAART between 1996 and 2007, aged 16 years or older, and had at least 1 measurement (HIV-1 RNA plasma viral load or CD4 cell count) at 6 months of therapy (3-9 month window) were included. Therapy response was categorized as complete, discordant (virologic only or immunologic only), and absent. Associations between 6-month response to therapy and all-cause mortality were assessed by Cox proportional hazards regression. Robust standard errors were calculated to account for intrasite correlation.
resultsA total of 7160 patients, corresponding to 15,107 person-years, were analyzed. In multivariable analysis adjusted for age at HAART initiation, baseline clinical stage and CD4 cell count, year of HAART initiation, clinic, occurrence of an AIDS-defining condition within the first 6 months of treatment, and discordant and absent responses were associated with increased risk of death.
conclusionsSimilar to reports from high-income countries, discordant immunologic and virologic responses were associated with intermediate risk of death compared with complete and no response in this large cohort of HIV-1 patients from resource-limited countries. Our results support a recommendation for wider availability of plasma viral load testing to monitor antiretroviral therapy in these settings.
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