Trial reportAIDS (London, England)2014
Successful antiretroviral therapy delivery and retention in care among asymptomatic individuals with high CD4+ T-cell counts above 350 cells/μl in rural Uganda.
Trial report in AIDS (London, England), 2014. 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 26 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.
Early Antiretroviral Therapy in Resource Limited Settings in Patients With High CD4+ Cell Counts (EARLI)
Sustainable East Africa Research in Community Health
Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- Costs of streamlined HIV care delivery in rural Ugandan and Kenyan clinics in the SEARCH Studys.AIDS (London, England) · 2018Trial
- Predictors of Retention in HIV Care Among Youth (15-24) in a Universal Test-and-Treat Setting in Rural Kenya.Journal of acquired immune deficiency syndromes (1999) · 2017Trial
- High rates of viral suppression in adults and children with high CD4+ counts using a streamlined ART delivery model in the SEARCH trial in rural Uganda and Kenya.Journal of the International AIDS Society · 2017Trial
- Multilevel Factors Influencing Linkage to HIV Care in a High HIV Prevalence District in South Africa: A Mixed Methods Approach.AIDS and behavior · 2026Article
- Early experiences with usage of long-acting injectable cabotegravir among adults in rural Ugandan and Kenyan communities: qualitative research from the SEARCH "Dynamic Choice HIV Prevention" intervention trials.Journal of the International AIDS Society · 2025Article
- Article
- Virologic suppression and associated factors in HIV infected Ugandan female sex workers: a cross-sectional study.African health sciences · 2021Article
- Tracking linkage to care in an anonymous HIV testing context: A field assessment in Mozambique.Journal of evaluation in clinical practice · 2020Article
- High viral suppression and low attrition in healthy HIV-infected patients initiated on ART with CD4 above 500 cells/µL in a program setting in Uganda.African health sciences · 2020Article
- Lost to follow up rate in the first year of ART in adults initiated in a universal test and treat programme: a retrospective cohort study in Ekurhuleni District, South Africa.The Pan African medical journal · 2020Article
- Article
- Changes in disclosure, adherence and healthcare interactions after the introduction of immediate ART initiation: an analysis of patient experiences in Swaziland.Tropical medicine & international health : TM & IH · 2019Article
- Early outcomes after implementation of treat all in Rwanda: an interrupted time series study.Journal of the International AIDS Society · 2019Observational
- Article
- High levels of viral suppression among East African HIV-infected women and men in serodiscordant partnerships initiating antiretroviral therapy with high CD4 counts and during pregnancy.AIDS research and human retroviruses · 2018Article
- Phased implementation of spaced clinic visits for stable HIV-positive patients in Rwanda to support Treat All.Journal of the International AIDS Society · 2017Article
- Moving toward test and start: learning from the experience of universal antiretroviral therapy programs for HIV-infected pregnant/ breastfeeding women.AIDS (London, England) · 2017Article
- Improving antiretroviral therapy adherence in resource-limited settings at scale: a discussion of interventions and recommendations.Journal of the International AIDS Society · 2017Article
- High levels of retention in care with streamlined care and universal test and treat in East Africa.AIDS (London, England) · 2016Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors.
Funding
Abstract
backgroundHIV antiretroviral therapy (ART) is being rapidly scaled up in sub-Saharan Africa, including recently patients with CD4 T-cell counts above 350 cells/μl. However, concerns persist about adherence and virologic suppression among these asymptomatic, high CD4 cell count individuals.
objectiveTo determine the virologic efficacy and safety of ART among asymptomatic HIV-positive Ugandan adults with high CD4 cell counts above 350 cells/μl via a streamlined model of care.
designProspective nonrandomized clinical study (EARLI Study: clinicaltrials.gov NCT#01479634).
settingPrototypic rural Ugandan HIV clinic. PATIENTS/
participantsAsymptomatic, ART-naive adults (aged >18 years, N = 197) with CD4 at least 350 cells/μl, without pregnancy or WHO stage 3/4 illness.
interventionsART included tenofovir/emtricitabine/efavirenz, with ritonavir/lopinavir substitution for efavirenz available. Streamlined ART model included nurse-driven visits with physician back-up, basic safety laboratory monitoring with HIV viral load, clinician telephone contact, and defaulter tracking. No incentives were provided. OUTCOMES: Undetectable viral load (≤400 copies/ml) at 24 and 48 weeks [intention to treat (ITT); missing = detectable), self-reported ART adherence, retention in care, and laboratory/clinical ART toxicities.
resultsOf the 197 patients with CD4 above 350 cells/μl, median CD4 cell count was 569 cells/μl (interquartile range 451-716). Undetectable viral load was achieved in 189 of 197 (95.9%, ITT) and 189 of 195 (96.9%, ITT) of participants at weeks 24 and 48, respectively. Self-reported adherence was 98% and 192 of 197 (97%) of the patients were retained at week 48. Laboratory adverse events and hospitalizations were rare.
conclusionsWe demonstrate high virologic suppression, retention, and safety among asymptomatic individuals with CD4 above 350 cells/μl in a prototypic Ugandan clinic. Our results challenge current concerns that individuals with high CD4 cell count lack motivation for ART, and may not achieve sustained virologic suppression.
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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.