Evidence map›Paper›PMID 26361174›Full record

ArticleJournal of acquired immune deficiency syndromes (1999)2016

Changing Antiretroviral Eligibility Criteria: Impact on the Number and Proportion of Adults Requiring Treatment in Swaziland.

Naomi N Bock, Ruth C Emerson, Jason B Reed, Rejoice Nkambule, Deborah J Donnell, George T Bicego, Velephi Okello, Neena M Philip, Peter D Ehrenkranz, Yen T Duong and 2 more

Open access · greenAbstract read
In one paragraph

Article in Journal of acquired immune deficiency syndromes (1999), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.4field-weighted citation impact, top 35% 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

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.

  1. Pooled it
  2. 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

12 authors at 5 institutions in 2 countries.

Naomi N Bock*Centers for Disease Control and Prevention, Center for Global Health, Division of HIV/AIDS, Atlanta, GA; †Statistical Center for HIV/AIDS Research and Prevention and the Vaccine and Infectious Disease Institute, Fred Hutchinson Cancer Research Center, Seattle, WA; ‡Ministry of Health-Swaziland, Mbabane, Swaziland; §ICAP-Columbia, Mailman School of Public Health, Columbia University, New York, NY; and ‖Centers for Disease Control and Prevention, Mbabane, Swaziland.
Ruth C Emerson
Jason B Reed
Rejoice Nkambule
Deborah J Donnell
George T Bicego
Velephi Okello
Neena M Philip
Peter D Ehrenkranz
Yen T Duong
Janet S Moore
Jessica E Justman
Centers for Disease Control and Prevention · USCancer Research Center · USCenter for Global Health · USColumbia University · USMinistry of Health · SZ

Funding

RAPID SCALE UP OF HIV/AIDS CARE AND TREATMENT SERVICES IN THE KINGDOM OF SWAZILANU2GPS002005 · PS · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI JUSTMAN, JESSICA E. · 2009 to 2014
$46.8M
Intramural CDC HHS CC999999NCHHSTP CDC HHS U2G PS002005PHS HHS #5U2GPS002005
6 · The paper itself

Abstract

objectiveEarly initiation of antiretroviral treatment (ART) at CD4 cell count ≥ 500 cells per microliter reduces morbidity and mortality in HIV-infected adults. We determined the proportion of HIV-infected people with high viral load (VL) for whom transmission prevention would be an additional benefit of early treatment.

designA randomly selected subset of a nationally representative sample of HIV-infected adults in Swaziland in 2012.

methodsEight to 12 months after a national survey to determine adult HIV prevalence, 1067 of 5802 individuals identified as HIV-infected were asked to participate in a follow-up cross-sectional assessment. CD4 cell enumeration, VL measurements, and ART status were obtained to estimate the proportion of currently untreated adults and of the entire HIV-infected population with high VL (≥ 1000 copies/mL) whose treatment under a test-and-treat or VL threshold eligibility strategy would reduce HIV transmission.

resultsOf the 927 (87% of 1067) participants enrolled, 466 (50%) reported no ART use. Among them, 424 (91%) had VL ≥ 1000 copies per milliliter; of these, 148 (35%) were eligible for ART at the then existing CD4 count threshold of <350 cells per microliter; an additional 107 (25%) were eligible with expanded CD4 criterion of <500 cells per microliter; and 169 (40%) remained ART ineligible. Thus, 36% of the 466 currently untreated and 18% of the total 927 had high VL yet remained ART ineligible under a CD4 criterion of <500 cells per microliter.

conclusionsA test-and-treat or VL threshold for treatment eligibility is necessary to maximize the HIV transmission prevention benefits of ART.

Indexed as

AdolescentAdultAnti-HIV AgentsCD4 Lymphocyte CountCross-Sectional StudiesEswatiniFemaleHIV InfectionsHumansIncidenceMaleMiddle AgedPatient CompliancePractice Guidelines as TopicPrevalenceViral LoadAnti-HIV Agents

Identifiers

PMID26361174
PMCPMC4752404
OpenAlexW2414335808

What OpenQuestion holds

Textmetadata
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.