Evidence map›Paper›PMID 25865372›Full record

ArticleJournal of the International AIDS Society2015

Temporal trends of time to antiretroviral treatment initiation, interruption and modification: examination of patients diagnosed with advanced HIV in Australia.

Stephen T Wright, Matthew G Law, David A Cooper, Phillip Keen, Ann McDonald, Melanie Middleton, Ian Woolley, Mark Kelly, Kathy Petoumenos, Australian HIV Observational Database

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the International AIDS Society, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
0.6field-weighted citation impact, top 33% 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

7 citing papers in PubMed, 11 citations in OpenAlex.

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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

10 authors at 2 institutions in 1 country.

Stephen T WrightThe Kirby Institute, UNSW Australia, Sydney, Australia; swright@kirby.unsw.edu.au.
Matthew G LawThe Kirby Institute, UNSW Australia, Sydney, Australia.
David A CooperThe Kirby Institute, UNSW Australia, Sydney, Australia.
Phillip KeenThe Kirby Institute, UNSW Australia, Sydney, Australia.
Ann McDonaldThe Kirby Institute, UNSW Australia, Sydney, Australia.
Melanie MiddletonHealth Protection, Communicable Diseases Branch, NSW Government Health, Sydney, Australia.
Ian WoolleyDepartment of Medicine, Monash University, Melbourne, Australia.
Mark KellyBrisbane Sexual Health and HIV Services, Brisbane, Australia.
Kathy PetoumenosThe Kirby Institute, UNSW Australia, Sydney, Australia.
Australian HIV Observational Database
Government of New South Wales · AUMonash Medical Centre · AU

Funding

The Asia-Pacific HIV Research CollaborationU01AI069907 · NIAID · FOUNDATION FOR AIDS RESEARCH · PI ANNETTE H SOHN · 2006 to 2026
$44.8M
NIAID NIH HHS U01 AI069907NIAID NIH HHS U01-AI069907
6 · The paper itself

Abstract

introductionHIV prevention strategies are moving towards reducing plasma HIV RNA viral load in all HIV-positive persons, including those undiagnosed, treatment naïve, on or off antiretroviral therapy. A proxy population for those undiagnosed are patients that present late to care with advanced HIV. The objectives of this analysis are to examine factors associated with patients presenting with advanced HIV, and establish rates of treatment interruption and modification after initiating ART.

methodsWe deterministically linked records from the Australian HIV Observational Database to the Australian National HIV Registry to obtain information related to HIV diagnosis. Logistic regression was used to identify factors associated with advanced HIV diagnosis. We used survival methods to evaluate rates of ART initiation by diagnosis CD4 count strata and by calendar year of HIV diagnosis. Cox models were used to determine hazard of first ART treatment interruption (duration >30 days) and time to first major ART modification.

resultsFactors associated (p<0.05) with increased odds of advanced HIV diagnosis were sex, older age, heterosexual mode of HIV exposure, born overseas and rural-regional care setting. Earlier initiation of ART occurred at higher rates in later periods (2007-2012) in all diagnosis CD4 count groups. We found an 83% (69, 91%) reduction in the hazard of first treatment interruption comparing 2007-2012 versus 1996-2001 (p<0.001), and no difference in ART modification for patients diagnosed with advanced HIV.

conclusionsRecent HIV diagnoses are initiating therapy earlier in all diagnosis CD4 cell count groups, potentially lowering community viral load compared to earlier time periods. We found a marked reduction in the hazard of first treatment interruption, and found no difference in rates of major modification to ART by HIV presentation status in recent periods.

Indexed as

AdultAgedAnti-HIV AgentsAustraliaCD4 Lymphocyte CountFemaleHIV InfectionsHumansLogistic ModelsMaleMiddle AgedTime FactorsViral LoadAnti-HIV Agentsadvanced HIV diagnosiscombination antiretroviral therapylate diagnosistreatment interruptiontreatment modification

Identifiers

PMID25865372
PMCPMC4394156
OpenAlexW1985999060

What OpenQuestion holds

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LicenceCC BY
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.