Evidence map›Paper›PMID 23678201›Full record

SynthesisBulletin of the World Health Organization2013

Viral suppression after 12 months of antiretroviral therapy in low- and middle-income countries: a systematic review.

James H McMahon, Julian H Elliott, Silvia Bertagnolio, Rachel Kubiak, Michael R Jordan

2 registry-linked trialsAbstract readSystematic Review
In one paragraph

Synthesis in Bulletin of the World Health Organization, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 88 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
88citing papers in PubMed, 5 pooled it
–field-weighted citation impact
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.

NCT03394391 nacompletednot on this mapstarted 2018, after this paper: background citation

A Single-blind, Randomized, Parallel Design Study to Assess the Effectiveness of SMS Reminders in Improving ART Adherence Among Adolescents Living With HIV in Nigeria (STARTA Trial-Adolescents)

TypeinterventionalSponsorDr. Olumide ABIODUNRan2018 to 2019Enrolled212ConditionsHIV InfectionsArmsDaily ART-adherence SMS reminder, Standard Adherence Counselling/Patient experience group chat
NCT03438370 naunknown statusnot on this mapstarted 2017, after this paper: background citation

Outcomes of Differentiated Models of Antiretroviral Treatment (ART) Provision: Multi-Month Dispensing (MMD) of ART in Community ART Distribution for Stable HIV Infected Patients

TypeinterventionalSponsorEquip, LesothoRan2017 to 2019Enrolled5,760ConditionsHIV/AIDSArmsThree monthly ART supply at CAGs, Six monthly ART supply at outreaches
3 · Its place in the literature

Who cites it

88 citing papers in PubMed, 5 syntheses or guidelines pooled it.

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  3. Long-term Virological Outcomes of First-Line Antiretroviral Therapy for HIV-1 in Low- and Middle-Income Countries: A Systematic Review and Meta-analysis.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2015
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28 more citing papers are in PubMed but not listed here.

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

5 authors.

James H McMahonInfectious Diseases Unit, Alfred Hospital, Level 2 Burnet Tower, 85 Commercial Road, Melbourne 3004, Australia.
Julian H Elliott
Silvia Bertagnolio
Rachel Kubiak
Michael R Jordan

Funding

Emergence of HIV drug resistance: Low-frequency mutations and associated factorsK23AI074423 · NIAID · TUFTS MEDICAL CENTER · PI JORDAN, MICHAEL ROBERT · 2007 to 2011
$667k
NIAID NIH HHS 5K23AI074423-04NIAID NIH HHS K23 AI074423
6 · The paper itself

Abstract

objectiveTo establish estimates of viral suppression in low- and middle-income countries (LMICs) in patients who received antiretroviral therapy (ART) for human immunodeficiency virus (HIV) infection.

methodsData on viral suppression after 12 months of ART in LMICs were collected from articles published in 2003 to 2011 and from abstracts of conferences held between 2009 and 2011. Pooled proportions for on-treatment and intention-to-treat populations were used as summary estimates. Random-effects models were used for heterogeneous groups of studies (I (2) > 75%).

findingsOverall, 49 studies covering 48 cohorts and 30 016 individuals met the inclusion criteria. With thresholds for suppression between 300 and 500 copies of viral ribonucleic acid (RNA) per ml of plasma, 84.3% (95% confidence interval, CI: 80.4-87.9) of the pooled on-treatment population and 70.5% (95% CI: 65.2-75.6) of the intention-to-treat population showed suppression. Use of different viral RNA thresholds changed the proportions showing suppression: to 84% and 76% of the on-treatment population with thresholds set above 300 and at or below 200 RNA copies per ml, respectively, and to 78%, 71% and 63% of the intention-to-treat population at thresholds set at 1000, 300 to 500, and 200 or fewer copies per ml, respectively.

conclusionThe pooled estimates of viral suppression recorded after 12 months of ART in LMICs provide benchmarks that other ART programmes can use to set realistic goals and perform predictive modelling. Evidence from this review suggests that the current international target - i.e. viral suppression in > 70% of the intention-to-treat population, with a threshold of 1000 copies per ml - should be revised upwards.

Indexed as

Developing CountriesAnti-Retroviral AgentsGlobal HealthHIV InfectionsHumansRNA, ViralAnti-Retroviral AgentsRNA, Viral

Identifiers

PMID23678201
PMCPMC3646348

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.