Evidence map›Paper›PMID 26426197›Full record

ArticleJournal of the International AIDS Society2015

Lack of awareness of treatment failure among HIV-1-infected patients in Guinea-Bissau - a retrospective cohort study.

Sanne Jespersen, Bo Langhoff Hønge, Candida Medina, David da Silva Té, Faustino Gomes Correira, Alex Lund Laursen, Christian Erikstrup, Lars Østergaard, Christian Wejse, Bissau HIV Cohort study group

Open access · goldAbstract read
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 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
1.2field-weighted citation impact, top 23% 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

8 citing papers in PubMed, 19 citations in OpenAlex.

  1. Article
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  4. Review
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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 4 institutions in 2 countries.

Sanne JespersenBandim Health Project, Indepth Network, Bissau, Guinea-Bissau.
Bo Langhoff HøngeBandim Health Project, Indepth Network, Bissau, Guinea-Bissau.
Candida MedinaNational HIV Programme, Ministry of Health, Bissau, Guinea-Bissau.
David da Silva TéNational HIV Programme, Ministry of Health, Bissau, Guinea-Bissau.
Faustino Gomes CorreiraNational HIV Programme, Ministry of Health, Bissau, Guinea-Bissau.
Alex Lund LaursenDepartment of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark;
Christian ErikstrupDepartment of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark.
Lars ØstergaardDepartment of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark;
Christian WejseBandim Health Project, Indepth Network, Bissau, Guinea-Bissau.
Bissau HIV Cohort study group
Aarhus University Hospital · DKNational Institute of Public Health · GWBandim Health Project · GWAarhus University · DK

Funding

WADA (West Africa Database on Antiretroviral Therapy) CollaborationU01AI069919 · NIAID · UNIVERSITY OF BORDEAUX II · PI Didier Koumavi Ekouevi, Antoine Jaquet · 2006 to 2026
$29.9M
NIAID NIH HHS U01 AI069919NIAID NIH HHS U01AI069919
6 · The paper itself

Abstract

introductionWith more people receiving antiretroviral treatment (ART), the need to detect treatment failure and switch to second-line ART has also increased. We assessed CD4 cell counts (as a marker of treatment failure), determined the rate of switching to second-line treatment and evaluated mortality related to treatment failure among HIV-infected patients in Guinea-Bissau.

methodsIn this retrospective cohort study, adult patients infected with HIV-1 receiving ≥6 months of ART at an HIV clinic in Bissau were included from June 2005 to July 2014 and followed until January 2015. Treatment failure was defined as 1) a fall in CD4 count to baseline (or below) or 2) CD4 levels persistently below 100 cells/µL after ≥6 months of ART. Cox hazard models, with time since six months of ART as the time-varying coefficient, were used to estimate the hazard ratio for death and loss to follow-up.

resultsWe assessed 1,591 HIV-1-infected patients for immunological treatment failure. Treatment failure could not be determined in 594 patients (37.3%) because of missing CD4 cell counts. Among the remaining 997 patients, 393 (39.4%) experienced failure. Only 39 patients (9.9%) with failure were switched from first- to second-line ART. The overall switching rate was 3.1 per 100 person-years. Mortality rate was higher in patients with than without treatment failure, with adjusted hazard rate ratios (HRRs) 10.0 (95% CI: 0.9-107.8), 7.6 (95% CI: 1.6-35.5) and 3.1 (95% CI: 1.5-6.3) in the first, second and following years, respectively. During the first year of follow-up, patients experiencing treatment failure had a higher risk of being lost to follow-up than patients not experiencing treatment failure (adjusted HRR 4.4; 95% CI: 1.7-11.8).

conclusionsWe found a high rate of treatment failure, an alarmingly high number of patients for whom treatment failure could not be assessed, and a low rate of switching to a second-line therapy. These factors could lead to an increased risk of resistance development and excess mortality.

Indexed as

HIV-1AdultAgedAwarenessCD4 Lymphocyte CountCohort StudiesFemaleGuinea-BissauHIV InfectionsHumansMaleMiddle AgedProportional Hazards ModelsRetrospective StudiesTreatment FailureAfricaCD4 cell countGuinea-BissauHIVtreatment failureviral load

Identifiers

PMID26426197
PMCPMC4590343
OpenAlexW1950228721

What OpenQuestion holds

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LicenceCC BY
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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.