Evidence map›Paper›PMID 25232730›Full record

ArticlePloS one2014

Induction with lopinavir-based treatment followed by switch to nevirapine-based regimen versus non-nucleoside reverse transcriptase inhibitors-based treatment for first line antiretroviral therapy in HIV infected children three years and older.

Gerardo Alvarez-Uria, Raghavakalyan Pakam, Praveen Kumar Naik, Manoranjan Midde

Registry-linked trialOpen access · goldAbstract read
In one paragraph

Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02454569 (Vicente Ferrer HIV Cohort Study), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.2field-weighted citation impact, top 47% 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.

NCT02454569 recruitingnot on this map

Vicente Ferrer HIV Cohort Study

Typeobservational_patient_registrySponsorRural Development Trust HospitalRan2009 to 2040Enrolled30,000ConditionsHIV, Tuberculosis, Cryptococcosis, Opportunistic Infections
3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. 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

4 authors at 1 institution in 1 country.

Gerardo Alvarez-UriaDepartment of Infectious Diseases, Rural Development Trust Hospital, Bathalapalli, AP, India.
Raghavakalyan PakamDepartment of Infectious Diseases, Rural Development Trust Hospital, Bathalapalli, AP, India.
Praveen Kumar NaikDepartment of Infectious Diseases, Rural Development Trust Hospital, Bathalapalli, AP, India.
Manoranjan MiddeDepartment of Infectious Diseases, Rural Development Trust Hospital, Bathalapalli, AP, India.
Medical Trust Hospital · IN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe World Health Organization recommends non-nucleoside reverse transcriptase inhibitors (NNRTIs)-based antiretroviral therapy (ART) for children three years and older. In younger children, starting ART with lopinavir boosted with ritonavir (LPVr) results in lower risk of virological failure, but data in children three years and older are scarce, and long-term ART with LPVr is problematic in resource-poor settings. METHODOLOGY: Retrospective cohort of children three years and older who started triple ART including LPVr or a NNRTI between 2007 and 2013 in a rural setting in India. Children who started LPVr were switched to nevirapine-based ART after virological suppression. We analysed two outcomes, virological suppression (HIV-RNA <400 copies/ml) within one year of ART using logistic regression, and time to virological failure (HIV-RNA >1000 copies/ml) after virological suppression using Cox proportional hazard regression. A sensitivity analysis was performed using inverse probability of treatment weighting (IPTW) based of propensity score methods.

findingsOf 325 children having a viral load during the first year of ART, 74/83 (89.2%) in the LPVr group achieved virological suppression versus 185/242 (76.5%) in the NNRTI group. In a multivariable analysis, the use of LPVr-based ART was associated with higher probability of virological suppression (adjusted odds ratio 3.19, 95% confidence interval [CI] 1.11-9.13). After IPTW, the estimated risk difference was 12.2% (95% CI, 2.9-21.5). In a multivariable analysis including 292 children who had virological suppression and available viral loads after one year of ART, children switched from LPVr to nevirapine did not have significant higher risk of virological failure (adjusted hazard ratio 1.18, 95% CI 0.36-3.81).

conclusionsIn a cohort of HIV infected children three years and older in a resource-limited setting, an LPVr induction- nevirapine maintenance strategy resulted in more initial virological suppression and similar incidence of virological failure after initial virological suppression than NNRTI-based regimens.

Indexed as

ChildChild, PreschoolDrug Resistance, ViralDrug SubstitutionDrug Therapy, CombinationFemaleHIV InfectionsHIV Protease InhibitorsHumansInduction ChemotherapyLopinavirMaleNevirapineRetrospective StudiesTreatment OutcomeViral LoadHIV Protease InhibitorsLopinavirNevirapine

Identifiers

PMID25232730
PMCPMC4169483
OpenAlexW2018392367

What OpenQuestion holds

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LicenceCC BY
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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.