Evidence map›Paper›PMID 23639243›Full record

Trial reportJournal of the International AIDS Society2013

Early upper digestive tract side effects of zidovudine with tenofovir plus emtricitabine in West African adults with high CD4 counts.

Eric Ouattara, Christine Danel, Raoul Moh, Delphine Gabillard, Gilles Peytavin, Romuald Konan, Jérome Le Carrou, Franck Bohoussou, Serge P Eholie, Xavier Anglaret

Registry-linked trialOpen access · goldAbstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in Journal of the International AIDS Society, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00495651 (Benefits and Risks of Early Antiretroviral Therapy in HIV-infected Adults in Abidjan, Côte d'Ivoire), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.0field-weighted citation impact, top 24% 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.

NCT00495651 phase3completednot on this map

Benefits and Risks of Early Antiretroviral Therapy in HIV-infected Adults in Abidjan, Côte d'Ivoire: Randomized Controlled Trial (ANRS 12136 TEMPRANO)

TypeinterventionalSponsorFrench National Agency for Research on AIDS and Viral HepatitisRan2008 to 2015Enrolled2,073ConditionsHIV Infections, TuberculosisArmsAntiretroviral medications, Antiretroviral medications+Isoniazid prophylaxis
3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 14 citations in OpenAlex.

  1. Trial
  2. Article
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

10 authors at 6 institutions in 2 countries.

Eric OuattaraProgramme PACCI, Abidjan, Côte d'Ivoire; Univ. Bordeaux, ISPED, F-33000 Bordeaux, France.
Christine Danel
Raoul Moh
Delphine Gabillard
Gilles Peytavin
Romuald Konan
Jérome Le Carrou
Franck Bohoussou
Serge P Eholie
Xavier Anglaret
Programme PAC-CI · CIUniversité de Bordeaux · FRBordeaux Population Health · FRHôpital Bichat-Claude-Bernard · FRInserm · FRUniversity Hospital Medical Center at Treichville · CI

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionTenofovir (TDF) with emtricitabine (FTC) and zidovudine (ZDV) is a recognized alternate first-line antiretroviral (ART) regimen for patients who cannot start treatment with non-nucleoside reverse transcriptase inhibitors (NNRTIs). Clinical studies comparing TDF+FTC+ZDV to other regimens are lacking.

methodsParticipants in a trial of early ART in Côte d'Ivoire (Temprano ANRS 12136) started treatment with TDF/FTC plus either efavirenz (EFV) or ZDV (HIV-1+2 dually infected patients and women refusing contraception or previously treated with nevirapine). We compared rates of upper digestive serious adverse events (sAEs) between TDF/FTC+EFV and TDF/FTC+ZDV patients during the first six months of treatment. sAEs were defined as either grade 3-4 AEs or persistent grade 1-2 AEs leading to drug discontinuation.

resultsA total of 197 patients (76% women, median CD4 count 395/mm(3)) started therapy with TDF/FTC, 126 with EFV and 71 with ZDV. During the first six months of ART, 94 patients had digestive AEs (nausea/vomiting) of any grade (EFV 36/126, 29%; ZDV 58/71, 82%, p<0.0001), including 20 sAEs (EFV 3/126, 5%; ZDV 17/71, 24%, p<0.0001). In-patients on TDF/FTC+ZDV with digestive AEs, the median time to the first symptom was two days (IQR: 1-4). Plasma ZDV (Cmax) distributions and pill ZDV dosages were normal. Patients with digestive AEs had higher haemoglobin levels and tended to have higher body mass indices and more frequent past histories of cotrimoxazole (CTX) prophylaxis.

conclusionsWe observed an unexpectedly high rate of digestive sAEs in West African adults, mostly women, who started a 3-nuc ART with TDF/FTC+ZDV in Côte d'Ivoire. These adults were participating in a trial of early ART and had much higher CD4 counts than those who currently routinely start ART in sub-Saharan Africa. They all received CTX concomitantly with ZDV. We suggest that further early prescriptions of TDF+XTC+ZDV should be carefully monitored and that whenever possible, the rate of early upper digestive adverse events should be compared to that occurring in-patients taking other drug regimens. CLINICAL TRIAL NUMBER: NCT00495651.

Indexed as

AdenineAdultAnti-HIV AgentsCD4 Lymphocyte CountCote d'IvoireDeoxycytidineDrug-Related Side Effects and Adverse ReactionsDrug Therapy, CombinationEmtricitabineFemaleGastrointestinal DiseasesHIV InfectionsHumansMaleMiddle AgedOrganophosphonatesAdenineAnti-HIV AgentsDeoxycytidineEmtricitabineOrganophosphonatesTenofovirZidovudine3 nucleoside reverse transcriptase inhibitorsadultsantiretroviral treatmentearly treatmentHIV infectionside effectssub-Saharan Africatolerance

Identifiers

PMID23639243
PMCPMC3643089
OpenAlexW2060785884

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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.