SynthesisJournal of acquired immune deficiency syndromes (1999)2010
Effect of directly observed therapy for highly active antiretroviral therapy on virologic, immunologic, and adherence outcomes: a meta-analysis and systematic review.
Synthesis 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. An erratum has been issued. Cited by 60 papers, 6 of them syntheses that pooled 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.
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.
Who cites it
60 citing papers in PubMed, 6 syntheses or guidelines pooled it, 121 citations in OpenAlex.
- Pooled it
- Interventions to improve safe and effective medicines use by consumers: an overview of systematic reviews.The Cochrane database of systematic reviews · 2014Pooled it
- Effect of home-based interventions on virologic outcomes in adults receiving antiretroviral therapy in Africa: a meta-analysis.BMC public health · 2014Pooled it
- A systematic review of antiretroviral adherence interventions for HIV-infected people who use drugs.Current HIV/AIDS reports · 2012Pooled it
- Interventions to improve adherence to antiretroviral therapy in children with HIV infection.The Cochrane database of systematic reviews · 2011Pooled it
- Interventions to increase antiretroviral adherence in sub-Saharan Africa: a systematic review of evaluation studies.The Lancet. Infectious diseases · 2011Pooled it
- Community-Based Accompaniment with Supervised Antiretrovirals for HIV-Positive Adults in Peru: A Cluster-Randomized Trial.AIDS and behavior · 2018Trial
- Directly observed therapy of sofosbuvir/ribavirin +/- peginterferon with minimal monitoring for the treatment of chronic hepatitis C in people with a history of drug use in Chennai, India (C-DOT).Journal of viral hepatitis · 2018Trial
- Effect of directly observed antiretroviral therapy compared to self-administered antiretroviral therapy on adherence and virological outcomes among HIV-infected prisoners: a randomized controlled pilot study.AIDS and behavior · 2015Trial
- Effect of a smartphone application incorporating personalized health-related imagery on adherence to antiretroviral therapy: a randomized clinical trial.AIDS patient care and STDs · 2014Trial
- A randomized controlled trial examining the efficacy of motivational counseling with observed therapy for antiretroviral therapy adherence.AIDS and behavior · 2013Trial
- Cost of behavioral interventions utilizing electronic drug monitoring for antiretroviral therapy adherence.Journal of acquired immune deficiency syndromes (1999) · 2013Trial
- Improved completion rates and characterization of drug reactions with an intensive Chagas disease treatment program in rural Bolivia.PLoS neglected tropical diseases · 2013Trial
- Trial
- Rationale, study design and sample characteristics of a randomized controlled trial of directly administered antiretroviral therapy for HIV-infected prisoners transitioning to the community - a potential conduit to improved HIV treatment outcomes.Contemporary clinical trials · 2012Trial
- Lack of sustained improvement in adherence or viral load following a directly observed antiretroviral therapy intervention.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2011Trial
- Directly observed antiretroviral therapy in substance abusers receiving methadone maintenance therapy does not cause increased drug resistance.AIDS research and human retroviruses · 2011Trial
- Study design and participant characteristics of a randomized controlled trial of directly administered antiretroviral therapy in opioid treatment programs.BMC infectious diseases · 2011Trial
- Support provided by outreach team leaders to caregivers of HIV/AIDS orphans in the North-West province of South Africa.BMC nursing · 2024Article
- Hydroxyurea mobile directly observed therapy versus standard monitoring in patients with sickle cell anemia: a phase 2 randomized trial.Communications medicine · 2024Article
Corrections and comments
- Commented on by
- Erratum issued
Authors and funding
7 authors at 4 institutions in 1 country.
Funding
Abstract
introductionDirectly observed therapy of highly active antiretroviral therapy (DOT-HAART) is a feasible adherence intervention. Prospective DOT-HAART studies have shown mixed results, and optimal target groups have yet to be defined. We performed a meta-analysis and systematic review to assess the effect of DOT-HAART on adherence and virologic and immunologic response.
methodsWe performed a comprehensive search through August 2009 to identify peer-reviewed controlled studies that involved outpatient DOT-HAART among adults and reported at least 1 outcome assessed in this meta-analysis. Random-effects meta-analyses were performed; differences in effect on virologic suppression were examined using stratified meta-analyses and meta-regression on several study characteristics.
resultsSeventeen studies met inclusion criteria. Compared with control groups, DOT-HAART recipients were more likely to achieve an undetectable viral load (random effects risk ratio 1.24, 95% confidence interval (CI): 1.08 to 1.41), a greater increase in CD4 cell count (random effects weighted mean difference 43 cells/microL, 95% CI: 12 to 74 cells/microL), and HAART adherence of > or =95% (random effects risk ratio 1.17, 95% CI: 1.03 to 1.32). Results varied with respect to virologic response. DOT-HAART did not have a significant effect on virologic suppression when restricted to randomized controlled studies. Post-treatment effect was not observed in a limited number of studies.
conclusionsDOT-HAART had a significant effect on virologic, immunologic, and adherence outcomes, although its efficacy was not supported when restricting analysis to randomized controlled trials. DOT-HAART shows greatest treatment effect when targeting individuals with greater risk of nonadherence and when delivering the intervention that maximizes participant convenience and provides enhanced adherence support. Further investigation is needed to assess the postintervention effect and cost-effectiveness of DOT-HAART.
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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.