Evidence map›Paper›PMID 25695494›Full record

ArticlePloS one2015

Factors associated with virological failure and suppression after enhanced adherence counselling, in children, adolescents and adults on antiretroviral therapy for HIV in Swaziland.

Kiran Jobanputra, Lucy Anne Parker, Charles Azih, Velephi Okello, Gugu Maphalala, Bernard Kershberger, Mohammed Khogali, Johnny Lujan, Annick Antierens, Roger Teck and 3 more

2 registry-linked trialsOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in PloS one, 2015. 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 156 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
156citing papers in PubMed, 10 pooled it
9.7field-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.

NCT03242980 nacompletednot on this mapstarted 2017, after this paper: background citation

Short Adherence Intervention for Viral Re-suppression (SAVIR) Study: A Stepped Wedge Randomized Controlled Study to Assess the Effect of Standardized Adherence Counselling in Individuals With Unsuppressed Viral Load in Lesotho

TypeinterventionalSponsorSwiss Tropical & Public Health InstituteRan2017 to 2019Enrolled928ConditionsAdherence, Medication, HIV/AIDSArmsStructured adherence counseling
NCT03848728 nacompletednot on this mapstarted 2019, after this paper: background citation

Strategic Antiretroviral Therapy and HIV Testing for Youth in Rural Africa

TypeinterventionalSponsorUniversity of California, San FranciscoRan2019 to 2023Enrolled1,988ConditionsHIVArmsSEARCH Youth combination intervention
3 · Its place in the literature

Who cites it

156 citing papers in PubMed, 10 syntheses or guidelines pooled it, 235 citations in OpenAlex.

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96 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

13 authors at 6 institutions in 5 countries.

Kiran JobanputraMédecins Sans Frontières (Operational Centre Geneva), Mbabane, Swaziland.
Lucy Anne ParkerMédecins Sans Frontières (Operational Centre Geneva), Mbabane, Swaziland.
Charles AzihSwaziland National ART Program, Ministry of Health, Mbabane, Swaziland.
Velephi OkelloSwaziland National ART Program, Ministry of Health, Mbabane, Swaziland.
Gugu MaphalalaSwaziland National Reference Laboratory, Mbabane, Swaziland.
Bernard KershbergerMédecins Sans Frontières (Operational Centre Geneva), Mbabane, Swaziland.
Mohammed KhogaliMédecins Sans Frontières (Operational Research Unit), Luxembourg, Luxembourg.
Johnny LujanMédecins Sans Frontières (Operational Centre Geneva), Geneva, Switzerland.
Annick AntierensMédecins Sans Frontières (Operational Centre Geneva), Geneva, Switzerland.
Roger TeckMédecins Sans Frontières (Operational Centre Geneva), Geneva, Switzerland.
Tom EllmanMédecins Sans Frontières (Southern Africa Medical Unit), Cape Town, South Africa.
Rose KosgeiMédecins Sans Frontières (Operational Research Unit), Luxembourg, Luxembourg.
Tony ReidMédecins Sans Frontières (Operational Research Unit), Luxembourg, Luxembourg.
Médecins Sans Frontières · LUMédecins Sans Frontières · UGMédecins Sans Frontières · CHMinistry of Health · SZMédecins Sans Frontières · ZASwaziland National Trust Commission · SZ

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThis study explores factors associated with virological detectability, and viral re-suppression after enhanced adherence counselling, in adults and children on antiretroviral therapy (ART) in Swaziland.

methodsThis descriptive study used laboratory data from 7/5/2012 to 30/9/2013, which were linked with the national ART database to provide information on time on ART and CD4 count; information on enhanced adherence counselling was obtained from file review in health facilities. Multivariable logistic regression was used to explore the relationship between viral load, gender, age, time on ART, CD4 count and receiving (or not receiving) enhanced adherence counselling.

resultsFrom 12,063 patients undergoing routine viral load monitoring, 1941 (16%) had detectable viral loads. Children were more likely to have detectable viral loads (AOR 2.6, 95%CI 1.5-4.5), as were adolescents (AOR 3.2, 95%CI 2.2-4.8), patients with last CD4<350 cells/µl (AOR 2.2, 95%CI 1.7-2.9) or WHO Stage 3/4 disease (AOR 1.3, 95%CI 1.1-1.6), and patients on ART for longer (AOR 1.1, 95%CI 1.1-1.2). At retesting, 450 (54% of those tested) showed viral re-suppression. Children were less likely to re-suppress (AOR 0.2, 95%CI 0.1-0.7), as were adolescents (AOR 0.3, 95%CI 0.2-0.8), those with initial viral load> 1000 copies/ml (AOR 0.3, 95%CI 0.1-0.7), and those with last CD4<350 cells/µl (AOR 0.4, 95%CI 0.2-0.7). Receiving (or not receiving) enhanced adherence counselling was not associated with likelihood of re-suppression.

conclusionsChildren, adolescents and those with advanced disease were most likely to have high viral loads and least likely to achieve viral suppression at retesting; receiving adherence counselling was not associated with higher likelihood of viral suppression. Although the level of viral resistance was not quantified, this study suggests the need for ART treatment support that addresses the adherence problems of younger people; and to define the elements of optimal enhanced adherence support for patients of all ages with detectable viral loads.

Indexed as

CounselingAdolescentAdultAnti-HIV AgentsChildEswatiniFemaleHIV InfectionsHumansLogistic ModelsMaleViral LoadYoung AdultAnti-HIV Agents

Identifiers

PMID25695494
PMCPMC4335028
OpenAlexW1989878476

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.