SynthesisPloS one2013
Persistent difficulties in switching to second-line ART in sub-saharan Africa--a systematic review and meta-analysis.
Synthesis in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 35 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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.
Who cites it
35 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- Efficacy and safety of three second-line antiretroviral regimens in HIV-infected patients in Africa.AIDS (London, England) · 2015Trial
- Timeliness of switching to second-line antiretroviral therapy following virologic failure in Dar es Salaam, Tanzania.BMC research notes · 2026Article
- Framework for determining the optimal course of action when efficiency and affordability measures differ by perspective in cost-effectiveness analysis-with an illustrative case of HIV treatment in Mozambique.Cost effectiveness and resource allocation : C/E · 2023Article
- A Moving Target: Impacts of Lowering Viral Load Suppression Cutpoints on Progress Towards HIV Epidemic Control Goals.medRxiv : the preprint server for health sciences · 2023Article
- Article
- Magnitude and Factors Associated with Cytopenia Among Children on Highly Active Antiretroviral Therapy at Hawassa University College of Medicine and Health Science, Sidama Region, Southern Ethiopia.HIV/AIDS (Auckland, N.Z.) · 2023Article
- Assessment of HIV viral load monitoring in remote settings in Vietnam - comparing people who inject drugs to the other patients.PloS one · 2023Article
- Effect of Switching Antiretroviral Treatment Regimen in Patients With Drug-Resistant HIV-1 Infection: Retrospective Observational Cohort Study.JMIR public health and surveillance · 2022Observational
- Risk factors for sustained virological non-suppression among children and adolescents living with HIV in Zimbabwe and Malawi: a secondary data analysis.BMC pediatrics · 2022Article
- Time to Switch to Second-Line Anti-Retroviral Treatment and Its Predictors Among HIV Infected Adults with Virological Failure in Northwest Ethiopia: A Retrospective Follow-Up Study.HIV/AIDS (Auckland, N.Z.) · 2022Article
- Predictors of failure on second-line antiretroviral therapy with protease inhibitor mutations in Uganda.AIDS research and therapy · 2021Article
- The Impact of Delayed Switch to Second-Line Antiretroviral Therapy on Mortality, Depending on Definition of Failure Time and CD4 Count at Failure.American journal of epidemiology · 2020Article
- Zimbabwe's national third-line antiretroviral therapy program: Cohort description and treatment outcomes.PloS one · 2020Article
- Simplifying switch to second-line antiretroviral therapy in sub Saharan Africa: predicted effect of using a single viral load to define efavirenz-based first-line failure.AIDS (London, England) · 2019Article
- Point-of-care viral load monitoring: outcomes from a decentralized HIV programme in Malawi.Journal of the International AIDS Society · 2019Article
- An observational study in an urban Ugandan clinic comparing virological outcomes of patients switched from first-line antiretroviral regimens to second-line regimens containing ritonavir-boosted atazanavir or ritonavir-boosted lopinavir.BMC infectious diseases · 2019Observational
- Article
- First-line HIV treatment failures in non-B subtypes and recombinants: a cross-sectional analysis of multiple populations in Uganda.AIDS research and therapy · 2019Article
- Third-Line Antiretroviral Therapy Program in the South African Public Sector: Cohort Description and Virological Outcomes.Journal of acquired immune deficiency syndromes (1999) · 2019Article
Corrections and comments
- Erratum issued
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesSwitching to second-line antiretroviral therapy (ART) largely depends on careful clinical assessment and access to biological measurements. We performed a systematic review and meta-analysis to estimate the incidence of switching to second-line ART in sub-Saharan Africa and its main programmatic determinants.
methodsWe searched 2 databases for studies reporting the incidence rate of switching to second-line ART in adults living in sub-Saharan Africa. Data on the incidence rate of switching were pooled, and random-effect models were used to evaluate the effect of factors measured at the programme level on this incidence rate.
resultsNine studies (157,340 patients) in 21 countries were included in the meta-analysis. All studies considered patients under first-line ART and conditions to initiate ART were similar across studies. Overall, 3,736 (2.4%) patients switched to second-line ART. Incidence rate of switch was in mean 2.65 per 100 person-years (PY) (95% confidence interval: 2.01-3.30); it ranged from 0.42 to 4.88 per 100 PY and from 0 to 4.80 per 100 PY in programmes with and without viral load monitoring, respectively. No factors measured at the programme level were associated with the incidence rate of switching to second-line ART.
conclusionThe low incidence rate of switching to second-line ART suggests that the monitoring of patients under ART is challenging and that access to second-line ART is ineffective; efforts should be made to increase access to second-line ART to those in need by providing monitoring tools, education and training, as well as a more convenient regimen.
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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.