Evidence map›Paper›PMID 23943825›Full record

Trial reportClinical infectious diseases : an official publication of the Infectious Diseases Society of America2013

Low baseline CD4+ count is associated with greater bone mineral density loss after antiretroviral therapy initiation.

Philip M Grant, Douglas Kitch, Grace A McComsey, Michael P Dube, Richard Haubrich, Jeannie Huang, Sharon Riddler, Pablo Tebas, Andrew R Zolopa, Ann C Collier and 1 more

Open access · bronzeAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 68 papers.

0numbers the graph read from it
0cells of the map it votes in
68citing papers in PubMed
12.3field-weighted citation impact, top 1% 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

68 citing papers in PubMed, 107 citations in OpenAlex.

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  6. Less Bone Loss With Maraviroc- Versus Tenofovir-Containing Antiretroviral Therapy in the AIDS Clinical Trials Group A5303 Study.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2015
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8 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

11 authors at 8 institutions in 1 country.

Philip M GrantDivision of Infectious Diseases, Department of Medicine, Stanford University, Palo Alto, California.
Douglas Kitch
Grace A McComsey
Michael P Dube
Richard Haubrich
Jeannie Huang
Sharon Riddler
Pablo Tebas
Andrew R Zolopa
Ann C Collier
Todd T Brown
Stanford University · USUniversity of California, San Diego · USCase Western Reserve University · USHarvard University Press · USJohns Hopkins University · USUniversity of Pittsburgh · USUniversity of Southern California · USUniversity of Washington · US

Funding

Statistical and Data Management Center (SDMC), AIDS Clinical Trials Group (ACTG)UM1AI068634 · NIAID · HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH · PI Marlene Ann Cooper, Michael David Hughes · 2011 to 2026
$246.6M
AIDS Clinical Trials Group NetworkU01AI068636 · NIAID · SOCIAL AND SCIENTIFIC SYSTEMS, INC. · PI KURITZKES, DANIEL R. · 2006 to 2010
$147.1M
VirologyP30AI036214 · NIAID · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI David Mitchell Smith · 1994 to 2026
$78.4M
STATISTICAL AND DATA MANAGEMENT CENTERU01AI038855 · NIAID · HARVARD UNIVERSITY (SCH OF PUBLIC HLTH) · PI HUGHES, MICHAEL DAVID · 1996 to 2006
$78.1M
Statistical and Data Management Center for the AIDS Clinical Trials GroupU01AI068634 · NIAID · HARVARD SCHOOL OF PUBLIC HEALTH · PI HUGHES, MICHAEL DAVID · 2006 to 2010
$71.9M
UCSD Department of Medicine HIV/AIDS Clinical Trials UnitUM1AI069432 · NIAID · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI TIMOTHY J. WILKIN · 2012 to 2026
$50.4M
University of Pittsburgh Clinical Trials UnitUM1AI069494 · NIAID · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI SUSAN L KOLETAR, John W Mellors · 2012 to 2026
$38.0M
University of Pennsylvania HIV Clinical Trials UnitUM1AI069534 · NIAID · UNIVERSITY OF PENNSYLVANIA · PI Ian Frank, PABLO TEBAS · 2012 to 2026
$33.0M
UCSD Department of Medicine HIV/AIDS Clinical Trials UnitU01AI069432 · NIAID · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI BENSON, CONSTANCE ANN · 2007 to 2011
$19.3M
University of Pittsburgh Clinical Trials UnitU01AI069494 · NIAID · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI MELLORS, JOHN W · 2007 to 2011
$13.9M
UW Clinical HIV Integrated Research ProgramU01AI069434 · NIAID · UNIVERSITY OF WASHINGTON · PI COLLIER, ANN CORNWALL · 2007 to 2011
$5.6M
Penn prevention clinical trials unitU01AI069534 · NIAID · UNIVERSITY OF PENNSYLVANIA · PI METZGER, DAVID S · 2007 to 2011
$4.6M
NIAID NIH HHS AI064086NIAID NIH HHS AI065348NIAID NIH HHS AI068634NIAID NIH HHS AI069432NIAID NIH HHS AI36214NIAID NIH HHS AI38855NIAID NIH HHS K24 AI064086NIAID NIH HHS P30 AI036214NIAID NIH HHS R01 AI065348NIAID NIH HHS U01 AI038855NIAID NIH HHS U01 AI068634NIAID NIH HHS U01 AI068636NIAID NIH HHS U01AI068636NIAID NIH HHS U01 AI069432NIAID NIH HHS UM1 AI068634NIAID NIH HHS UM1 AI069432NIAID NIH HHS UM1 AI069434NIAID NIH HHS UM1AI069434NIAID NIH HHS UM1 AI069494NIAID NIH HHS UM1 AI069534
6 · The paper itself

Abstract

backgroundBone mineral density (BMD) decreases 2%-6% in the 2 years after antiretroviral therapy (ART) initiation. Pre-ART immune deficiency and early immune recovery may contribute to this loss.

methodsWe pooled data from 3 studies of ART initiation in treatment-naive patients in which serial whole-body dual-energy X-ray absorptiometry scans were performed. We used linear regression to evaluate effects of baseline CD4(+) and 16-week CD4(+) change (both absolute and relative) on 96-week total BMD change from baseline. We performed multivariable linear regression to assess associations between baseline variables of age, sex, race/ethnicity, body mass index (BMI), hepatitis C status, parent study, human immunodeficiency virus type 1 (HIV-1) RNA level, and assignment to a protease inhibitor (PI)- or tenofovir-containing regimen on 96-week total BMD change.

resultsThe included 796 subjects had mean 96-week total BMD loss of 2.0%. In multivariable analysis, baseline CD4(+) cell count was significantly associated with 96-week BMD loss; individuals with baseline CD4(+) <50 cells/µL lost significantly more BMD compared to those with CD4(+) ≥500 cells/µL. A greater relative, but not absolute, 16-week increase in CD4(+) count was significantly associated with greater declines in BMD, but not after controlling for baseline CD4(+) count. In multivariable analysis, older age, female sex, lower BMI, higher HIV-1 RNA levels, and PI and tenofovir assignment were also associated with greater BMD decline.

conclusionsLow pretreatment CD4(+) count, but not greater CD4(+) count increase, is a strong and independent risk factor for bone loss after ART initiation. ART initiation at higher CD4(+) counts may reduce the burden of osteoporosis and fragility fractures.

Indexed as

CD4 Lymphocyte CountAbsorptiometry, PhotonAdultAnalysis of VarianceAnti-HIV AgentsBone DensityFemaleHIV InfectionsHumansLinear ModelsMaleMiddle AgedRisk FactorsViral LoadAnti-HIV Agentsadministration and dosageanti-HIV agentsbone densitydrug therapy/virologyHIV infections

Identifiers

PMID23943825
PMCPMC3805172
OpenAlexW2141166715

What OpenQuestion holds

Textmetadata
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.