ArticleAIDS research and therapy2015
Third-line antiretroviral therapy in Africa: effectiveness in a Southern African retrospective cohort study.
Article in AIDS research and therapy, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 3 of them syntheses that pooled 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.
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.
Who cites it
21 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Viral load suppression rate of third-line antiretroviral therapy and its association with gender among HIV patients after second-line treatment failure in Africa: a systematic review and meta-analysis.BMC infectious diseases · 2025Pooled it
- Virological outcomes of third-line antiretroviral therapy in a global context: a systematic reviews and meta-analysis.AIDS research and therapy · 2024Pooled it
- Pooled it
- Third-line antiretroviral therapy in low-income and middle-income countries (ACTG A5288): a prospective strategy study.The lancet. HIV · 2019Trial
- HIV drug resistance, early treatment outcomes and impact of guidelines compliance after protease inhibitor-based second-line failure in a dedicated resistance clinic in western Kenya: a retrospective cohort study.Journal of the International AIDS Society · 2025Article
- Virologic outcomes with tenofovir-lamivudine-dolutegravir in adults failing PI-based second-line ART.Southern African journal of HIV medicine · 2024Article
- Evaluation of Circulating and Archived HIV-1 Integrase Drug-Resistance Variants among Patients on Third-Line ART in Cameroon: Implications for Dolutegravir-Containing Regimens in Resource-Limited Settings.Microbiology spectrum · 2022Article
- Third-line antiretroviral therapy, including raltegravir (RAL), darunavir (DRV/r) and/or etravirine (ETR), is well tolerated and achieves durable virologic suppression over 144 weeks in resource-limited settings: ACTG A5288 strategy trial.Journal of the International AIDS Society · 2022Article
- A retrospective descriptive investigation of adult patients receiving third-line antiretroviral therapy in the North West province, South Africa.African health sciences · 2020Article
- Zimbabwe's national third-line antiretroviral therapy program: Cohort description and treatment outcomes.PloS one · 2020Article
- Southern African HIV Clinicians Society guidelines for antiretroviral therapy in adults: 2020 update.Southern African journal of HIV medicine · 2020Article
- Resistance in patients failing integrase strand transfer inhibitors: a call to replace raltegravir with dolutegravir in third-line treatment in South Africa.Open forum infectious diseases · 2019Article
- Quantifying pediatric patient need for second- and third-line HIV treatment: A tool for decision-making in resource-limited settings.PloS one · 2019Article
- PhyloPi: An affordable, purpose built phylogenetic pipeline for the HIV drug resistance testing facility.PloS one · 2019Article
- Third-Line Antiretroviral Therapy Program in the South African Public Sector: Cohort Description and Virological Outcomes.Journal of acquired immune deficiency syndromes (1999) · 2019Article
- Predictors of switch to and early outcomes on third-line antiretroviral therapy at a large public-sector clinic in Johannesburg, South Africa.AIDS research and therapy · 2018Article
- Human Immunodeficiency Virus-1 Drug Resistance Patterns Among Adult Patients Failing Second-Line Protease Inhibitor-Containing Regimens in Namibia, 2010-2015.Open forum infectious diseases · 2018Article
- Article
- HIV-1 Drug Resistance and Third-Line Therapy Outcomes in Patients Failing Second-Line Therapy in Zimbabwe.Open forum infectious diseases · 2018Article
- Adult antiretroviral therapy guidelines 2017.Southern African journal of HIV medicine · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
Abstract
backgroundAn increasing number of patients in Africa are experiencing virologic failure on second-line antiretroviral therapy (ART) and those who develop resistance to protease inhibitors (PI) will require third-line ART, but no data on the outcomes of third-line are available from the region. We assessed the virologic outcomes and survival of patients started on salvage ART in a Southern African private sector disease management programme.
methodsRetrospective observational cohort study with linkage to the national death register. Adults (≥18 years) who started salvage ART between July 2007 and December 2011 were included. Salvage ART was defined by inclusion of darunavir or tipranavir in an ART regimen after having failed another PI. For Kaplan-Meier (KM) analysis, patients were followed up until event, or censored at death (only for virologic outcomes), leaving the programme, or April 2014.
results152 patients were included. Subtype was known for 113 patients: 111 (98 %) were infected with subtype C. All 152 had a genotype resistance test demonstrating major PI resistance mutations. Salvage drugs included were: darunavir/ritonavir (n = 149), tipranavir/ritonavir (n = 3), raltegravir (n = 58), and etravirine (n = 8). Median follow-up was 2.5 years (IQR = 1.5-3.3). 82.9 % achieved a viral load ≤400 copies/ml and 71.1 % ≤50 copies/ml. By the end of the study 17 (11.2 %) of the patients had died. The KM estimate of cumulative survival was 87.2 % at 2000 days.
conclusionsVirologic suppression was comparable to that demonstrated in clinical trials and observational studies of salvage ART drugs conducted in other regions. Few deaths occurred during short term follow-up. Third-line regimens for patients with multidrug resistant subtype C HIV in Africa are virologically and clinically effective.
Indexed as
Identifiers
What OpenQuestion holds
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.