Evidence map›Paper›PMID 20812949›Full record

Trial reportHIV medicine2011

Predictors of bacterial pneumonia in Evaluation of Subcutaneous Interleukin-2 in a Randomized International Trial (ESPRIT).

S L Pett, C Carey, E Lin, D Wentworth, J Lazovski, J M Miró, F Gordin, B Angus, M Rodriguez-Barradas, R Rubio and 4 more

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in HIV medicine, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.4field-weighted citation impact, top 35% 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

2 citing papers in PubMed, 12 citations in OpenAlex.

  1. Community-Acquired Pneumonia in HIV-Infected Individuals.Current infectious disease reports · 2014
    Article
  2. Review
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

14 authors at 10 institutions in 6 countries.

S L PettNational Centre in HIV Epidemiology and Clinical Research, University of New South Wales, Sydney, Australia. spett@nchecr.unsw.edu.au
C Carey
E Lin
D Wentworth
J Lazovski
J M Miró
F Gordin
B Angus
M Rodriguez-Barradas
R Rubio
G Tambussi
D A Cooper
S Emery
INSIGHT-ESPRIT Study Group
UNSW Sydney · AUSt Vincent's Hospital Sydney · AUConsorci Institut D'Investigacions Biomediques August Pi I Sunyer · ESÉcole Supérieure Privée d'Ingénierie et de Technologies · TNHouston Medical Center · USIRCCS Ospedale San Raffaele · ITJohn Radcliffe Hospital · GBResearch Institute Hospital 12 de Octubre · ESUniversity of Minnesota · USWashington DC VA Medical Center · 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
INTERNATIONAL PHASE III IL-2 STUDYU01AI046957 · NIAID · UNIVERSITY OF MINNESOTA TWIN CITIES · PI NEATON, JAMES DENNIS · 1999 to 2005
$56.4M
Medical Research Council MC_U122886352NIAID NIH HHS U01 AI046957NIAID NIH HHS U01 AI068641NIAID NIH HHS U01 AI46957
6 · The paper itself

Abstract

BACKGROUND AND

objectivesBacterial pneumonia still contributes to morbidity/mortality in HIV infection despite effective combination antiretroviral therapy (cART). Evaluation of Subcutaneous Interleukin-2 in a Randomized International Trial (ESPRIT), a trial of intermittent recombinant interleukin-2 (rIL-2) with cART vs. cART alone (control arm) in HIV-infected adults with CD4 counts ≥300cells/μL, offered the opportunity to explore associations between bacterial pneumonia and rIL-2, a cytokine that increases the risk of some bacterial infections.

methodsBaseline and time-updated factors associated with first-episode pneumonia on study were analysed using multivariate proportional hazards regression models. Information on smoking/pneumococcal vaccination history was not collected.

resultsIL-2 cycling was most intense in years 1-2. Over ≈7 years, 93 IL-2 [rate 0.67/100 person-years (PY)] and 86 control (rate 0.63/100 PY) patients experienced a pneumonia event [hazard ratio (HR) 1.06; 95% confidence interval (CI) 0.79, 1.42; P=0.68]. Median CD4 counts prior to pneumonia were 570cells/μL (IL-2 arm) and 463cells/μL (control arm). Baseline risks for bacterial pneumonia included older age, injecting drug use, detectable HIV viral load (VL) and previous recurrent pneumonia; Asian ethnicity was associated with decreased risk. Higher proximal VL (HR for 1 log(10) higher VL 1.28; 95% CI 1.11, 1.47; P<0.001) was associated with increased risk; higher CD4 count prior to the event (HR per 100 cells/μL higher 0.94; 95% CI 0.89, 1.0; P=0.04) decreased risk. Compared with controls, the hazard for a pneumonia event was higher if rIL-2 was received <180 days previously (HR 1.66; 95% CI 1.07, 2.60; P=0.02) vs.≥180 days previously (HR 0.98; 95% CI 0.70, 1.37; P=0.9). Compared with the control group, pneumonia risk in the IL-2 arm decreased over time, with HRs of 1.41, 1.71, 1.16, 0.62 and 0.84 in years 1, 2, 3-4, 5-6 and 7, respectively.

conclusionsBacterial pneumonia rates in cART-treated adults with moderate immunodeficiency are high. The mechanism of the association between bacterial pneumonia and recent IL-2 receipt and/or detectable HIV viraemia warrants further exploration.

Indexed as

HIV-1Adjuvants, ImmunologicAdultAIDS-Related Opportunistic InfectionsAntiretroviral Therapy, Highly ActiveCD4 Lymphocyte CountDrug Therapy, CombinationFemaleHIV InfectionsHumansInterleukin-2MaleMiddle AgedPneumonia, BacterialPredictive Value of TestsRecombinant ProteinsAdjuvants, ImmunologicInterleukin-2Recombinant Proteins

Identifiers

PMID20812949
PMCPMC3048911
OpenAlexW1594043715

What OpenQuestion holds

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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.