Observational studyBMC infectious diseases2013
Immuno-virologic outcomes and immuno-virologic discordance among adults alive and on anti-retroviral therapy at 12 months in Nigeria.
Observational study in BMC infectious diseases, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 5 of them syntheses that pooled it.
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Who cites it
45 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Accuracy of measures for antiretroviral adherence in people living with HIV.The Cochrane database of systematic reviews · 2022Pooled it
- Factors associated with antiretroviral treatment failure among people living with HIV on antiretroviral therapy in resource-poor settings: a systematic review and metaanalysis.Systematic reviews · 2020Pooled it
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- Major protease inhibitor drug resistance mutations among patients with virological failure on second-line antiretroviral therapy in Zimbabwe: a retrospective cross-sectional study.Virology journal · 2026Article
- Predictors of virological outcomes in patients with HIV on antiretroviral therapy in Osogbo, Nigeria: a cross-sectional study.BMC infectious diseases · 2025Article
- Providing anti-retroviral treatment did not achieve the ambition of 'Joint united nations program on HIV/AIDS (UNAIDS) among HIV positive patient in Ethiopia': a systematic review and meta-analysis.Journal of pharmaceutical policy and practice · 2024Review
- Long-term evolution of immunological and virological parameters in patients undergoing treatments for HIV-1 infection at the Day Hospital of Bobo-Dioulasso, Burkina Faso.The Pan African medical journal · 2023Article
- Immunovirological discordance among female sex workers who start antiretroviral therapy in Burkina Faso.BMC infectious diseases · 2022Article
- Prevalence and Predictors of Cytopenias in HIV-Infected Adults at Initiation of Antiretroviral Therapy in Mehal Meda Hospital, Central Ethiopia.Journal of blood medicine · 2022Article
- CD4+ cell count recovery after initiation of antiretroviral therapy in HIV-infected Ethiopian adults.PloS one · 2022Article
- Immunological and virological discordance among people living with HIV on highly active antiretroviral therapy in Tigray, Northern Ethiopia.BMC infectious diseases · 2021Article
- Predictors of failure on second-line antiretroviral therapy with protease inhibitor mutations in Uganda.AIDS research and therapy · 2021Article
- Predictors of Poor Adherence to CART and Treatment Failure at Second-Line Regimens Among Adults in Public Hospitals of Amhara Region, North-Western Ethiopia: A Retrospective Cohort Study.Patient preference and adherence · 2021Article
- Assessing eligibility for differentiated service delivery, HIV services utilization and virologic outcomes of adult HIV-infected patients in Sierra Leone: a pre-implementation analysis.Global health action · 2021Article
- Unsuppressed Viral Load Level in Public Health Facilities: Nonvirological Predictors among Adult Antiretroviral Therapy Users in Southwestern Ethiopia.HIV/AIDS (Auckland, N.Z.) · 2021Article
- Predictors of first-line antiretroviral therapy failure among adults and adolescents living with HIV/AIDS in a large prevention and treatment program in Nigeria.AIDS research and therapy · 2020Article
- Article
- Anemia risk factors among people living with HIV across the United States in the current treatment era: a clinical cohort study.BMC infectious diseases · 2020Article
Corrections and comments
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Authors and funding
11 authors.
Funding
Abstract
backgroundPredictors of immuno-virologic outcomes and discordance and their associations with clinical, demographic, socio-economic and behavioral risk factors are not well described in Nigeria since HIV viral load testing is not routinely offered in public HIV treatment programs.
methodsThe HACART study was a multi-center observational clinic-based cohort study of 2585 adults who started HAART between April 2008 and February 2009. A total of 628 patients were randomly selected at 12 months for immuno-virologic analyses.
resultsVirologic suppression rate (<400 copies/ml) was 76.7%, immunologic recovery rate (CD4 change from baseline ≥50 cells/mm3) was 77.4% and immuno-virologic discordance rate was 33%. In multivariate logistic regression, virologic failure was associated with age <30 years (OR 1.79; 95% CI: 1.17-2.67, p=0.03), anemia (Hemoglobin < 10 g/dl) (OR 1.71; 95% CI: 1.22-2.61, p=0.03), poor adherence (OR 3.82; 95% CI: 2.17-5.97, p=0.001), and post-secondary education (OR 0.60; 95% CI: 0.30-0.86, p=0.02). Immunologic failure was associated with male gender (OR 1.46; 95% CI: 1.04-2.45, p=0.04), and age <30 years (OR 1.50; 95% CI: 1.11-2.39, p=0.03). Virologic failure with immunologic success (VL-/CD4+) was associated with anemia (OR 1.80; 95% CI: 1.13-2.88, p=0.03), poor adherence (OR 3.90; 95% CI: 1.92-8.24, p=0.001), and post-secondary education (OR 0.40; 95% CI: 0.22-0.68, p=0.005).
conclusionsAlthough favorable immuno-virologic outcomes could be achieved in this large ART program, immuno-virologic discordance was observed in a third of the patients. Focusing on intensified treatment preparation and adherence, young patients, males, persons with low educational status and most importantly baseline anemia assessment and management may help address predictors of poor immuno-virologic outcomes, and improve overall HIV program impact. Viral load testing in addition to the CD4 testing should be considered to identify, characterize and address negative immuno-virologic outcomes and discordance.
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