Evidence map›Paper›PMID 26996992›Full record

ArticleJournal of the International AIDS Society2016

Health outcomes among HIV-positive Latinos initiating antiretroviral therapy in North America versus Central and South America.

Carina Cesar, John R Koethe, Mark J Giganti, Peter Rebeiro, Keri N Althoff, Sonia Napravnik, Angel Mayor, Beatriz Grinsztejn, Marcelo Wolff, Denis Padgett and 12 more

Open access · goldAbstract readComparative Study
In one paragraph

Article in Journal of the International AIDS Society, 2016. 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
1.6field-weighted citation impact, top 18% 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, 8 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

22 authors at 14 institutions in 7 countries.

Carina CesarInvestigaciones Clínicas, Fundación Huésped, Buenos Aires, Argentina; carina.cesar@huesped.org.ar.
John R KoetheDivision of Infectious Diseases, Vanderbilt University School of Medicine, Nashville, TN, USA.
Mark J GigantiDepartment of Biostatistics, Vanderbilt University School of Medicine, Nashville, TN, USA.
Peter RebeiroDivision of Infectious Diseases, Vanderbilt University School of Medicine, Nashville, TN, USA.
Keri N AlthoffDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Sonia NapravnikDepartment of Medicine, University of North Carolina, Chapel Hill, NC, USA.
Angel MayorDepartment of Internal Medicine, Universidad Central del Caribe, Bayamón, Puerto Rico.
Beatriz GrinsztejnInstituto de Pesquisa Clinica Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.
Marcelo WolffFundación Arriarán and Facultad de Medicina, Universidad de Chile, Santiago, Chile.
Denis PadgettInstituto Hondureño de Seguridad Social and Hospital Escuela Universitario, Tegucigalpa, Honduras.
Juan Sierra-MaderoInstituto Nacional de Ciencias Médicas y Nutrición, Mexico City, Mexico.
Eduardo GotuzzoInstituto de Medicina Tropical Alexander von Humboldt, Lima, Peru.
Timothy R SterlingDivision of Infectious Diseases, Vanderbilt University School of Medicine, Nashville, TN, USA.
James WilligDivision of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, USA.
Julie LevisonDivision of General Internal Medicine, Massachusetts General Hospital, and Harvard Medical School, Boston, MA, USA.
Mari KitahataDivision of Infectious Diseases, University of Washington, Seattle, WA, USA.
Maria C Rodriguez-BarradasInfectious Diseases Section, Michael E. De Bakey VAMC, Baylor College of Medicine, Houston, TX, USA.
Richard D MooreDepartment of Medicine, Johns Hopkins University, Baltimore, MD, USA.
Catherine McGowanDivision of Infectious Diseases, Vanderbilt University School of Medicine, Nashville, TN, USA.
Bryan E ShepherdDepartment of Biostatistics, Vanderbilt University School of Medicine, Nashville, TN, USA.
Pedro CahnInvestigaciones Clínicas, Fundación Huésped, Buenos Aires, Argentina.
Caribbean, Central and South America Network for HIV epidemiology (CCASAnet) and North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD)
Vanderbilt University · USJohns Hopkins University · USCentral University of the Caribbean · PRFundacion Arriarán · CLFundación Huésped · ARHarvard University · USInstituto Evandro Chagas · BRInstituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán · MXMichael E. DeBakey VA Medical Center · USUniversidad Metropolitana de Honduras · HNUniversity of Alabama at Birmingham · USUniversity of North Carolina at Chapel Hill · USUniversity of Washington · USZero to Three · US

Funding

Leadership and Operations Center (LOC), AIDS Clinical Trials Group (ACTG); LOC 1/UM1AI068636 · NIAID · UNIV OF NORTH CAROLINA CHAPEL HILL · PI Joseph J Eron, RAJESH T GANDHI · 2011 to 2026
$1073.1M
Statistical and Data Management Center (SDMC), AIDS Clinical Trials Group (ACTG)UM1AI068634 · NIAID · HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH · PI Marlene Ann Cooper, Michael David Hughes · 2011 to 2026
$246.6M
WOMEN'S HEALTH AGENDAU01AI038858 · NIAID · SOCIAL AND SCIENTIFIC SYSTEMS, INC. · PI BENSON, CONSTANCE ANN · 1996 to 2008
$157.5M
AIDS Clinical Trials Group NetworkU01AI068636 · NIAID · SOCIAL AND SCIENTIFIC SYSTEMS, INC. · PI KURITZKES, DANIEL R. · 2006 to 2010
$147.1M
UCSF CLINICAL AND TRANSLATIONAL SCIENCE INSTITUTEUL1RR024131 · NCRR · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI JOHNSTON, S. CLAIBORNE · 2006 to 2011
$111.2M
University of Washington/Fred Hutch Center for AIDS ResearchP30AI027757 · NIAID · UNIVERSITY OF WASHINGTON · PI Kenneth Sherr · 1988 to 2026
$104.9M
Unsolicited R24 for the CFAR-Network of Integrated Clinical Sciences, CNICSR24AI067039 · NIAID · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI Michael S. Saag · 2006 to 2026
$99.4M
Virology CoreP30AI027763 · NIAID · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI STEVEN Grant DEEKS · 1988 to 2026
$93.6M
Virology CoreP30AI027767 · NIAID · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI OLAF KUTSCH · 1988 to 2026
$84.1M
STATISTICAL AND DATA MANAGEMENT CENTERU01AI038855 · NIAID · HARVARD UNIVERSITY (SCH OF PUBLIC HLTH) · PI HUGHES, MICHAEL DAVID · 1996 to 2006
$78.1M
Studies of Ocular Complications of AIDS - Coordinating CenterU10EY008057 · NEI · JOHNS HOPKINS UNIVERSITY · PI VAN NATTA, MARK L · 1988 to 2012
$78.0M
Virology, Immunology, and Microbiology CoreP30AI050410 · NIAID · UNIV OF NORTH CAROLINA CHAPEL HILL · PI DAVID M. MARGOLIS · 2001 to 2026
$76.9M
CIHR CBR-86906CIHR CBR-94036CIHR HCP-97105CIHR TGF-96118Intramural NIH HHSNCATS NIH HHS KL2-TR000421NCATS NIH HHS KL2 TR002317NCATS NIH HHS UL1-TR000083NCI NIH HHS N02-CP55504NCI NIH HHS R01 CA165937NCI NIH HHS R01-CA165937NCI NIH HHS Z01-CP010176NCI NIH HHS Z01-CP010214NCRR NIH HHS M01-RR-00052NCRR NIH HHS UL1-RR024131NEI NIH HHS K23-EY013707NEI NIH HHS U10-EY08052NEI NIH HHS U10-EY08057NEI NIH HHS U10-EY08067NIAAA NIH HHS R01-AA16893NIAAA NIH HHS U01-AA013566NIAAA NIH HHS U01-AA020790NIAAA NIH HHS U24-AA020794NIAID NIH HHS 2-U01-AI069923NIAID NIH HHS K01-AI071754NIAID NIH HHS K01-AI093197NIAID NIH HHS K24-AI065298NIAID NIH HHS P30 AI027763NIAID NIH HHS P30-AI027763NIAID NIH HHS P30 AI036219NIAID NIH HHS P30-AI036219NIAID NIH HHS P30 AI094189NIAID NIH HHS P30-AI094189NIAID NIH HHS P30 AI110527NIAID NIH HHS P30-AI27757NIAID NIH HHS P30-AI27767NIAID NIH HHS P30-AI50410NIAID NIH HHS P30-AI54999NIAID NIH HHS R24-AI067039NIAID NIH HHS R56-AI102622NIAID NIH HHS U01 AI035004NIAID NIH HHS U01-AI069918NIAID NIH HHS U01 AI069923NIAID NIH HHS U01-AI31834NIAID NIH HHS U01-AI34989NIAID NIH HHS U01-AI34993NIAID NIH HHS U01-AI34994NIAID NIH HHS U01-AI35004NIAID NIH HHS U01-AI35039NIAID NIH HHS U01-AI35040NIAID NIH HHS U01-AI35041NIAID NIH HHS U01-AI35042NIAID NIH HHS U01-AI37613NIAID NIH HHS U01-AI37984NIAID NIH HHS U01-AI38855NIAID NIH HHS U01-AI38858NIAID NIH HHS U01-AI42590NIAID NIH HHS U01-AI68634NIAID NIH HHS U01-AI68636NIAID NIH HHS U01-AI69432NIAID NIH HHS U01-AI69434NIAID NIH HHS UM1 AI068634NIAID NIH HHS UM1 AI069476NIAID NIH HHS UM1-AI35043NICHD NIH HHS U01-HD32632NIDA NIH HHS F31-DA037788NIDA NIH HHS K24-DA00432NIDA NIH HHS R01 DA012568NIDA NIH HHS R01-DA04334NIDA NIH HHS R01-DA11602NIDA NIH HHS R01-DA12568NIDA NIH HHS U01 DA036297NIDA NIH HHS U01-DA036935NIMHD NIH HHS G12 MD007583NIMHD NIH HHS G12-MD007583NIMHD NIH HHS U54 MD007587NIMHD NIH HHS U54-MD007587NIMH NIH HHS K23 MH100978NIMH NIH HHS K23MH100978NIMH NIH HHS P30-MH62246PHS HHS 90047713PHS HHS 90051652PHS HHS CDC200-2006-18797
6 · The paper itself

Abstract

introductionLatinos living with HIV in the Americas share a common ethnic and cultural heritage. In North America, Latinos have a relatively high rate of new HIV infections but lower rates of engagement at all stages of the care continuum, whereas in Latin America antiretroviral therapy (ART) services continue to expand to meet treatment needs. In this analysis, we compare HIV treatment outcomes between Latinos receiving ART in North America versus Latin America.

methodsHIV-positive adults initiating ART at Caribbean, Central and South America Network for HIV (CCASAnet) sites were compared to Latino patients (based on country of origin or ethnic identity) starting treatment at North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) sites in the United States and Canada between 2000 and 2011. Cox proportional hazards models compared mortality, treatment interruption, antiretroviral regimen change, virologic failure and loss to follow-up between cohorts.

resultsThe study included 8400 CCASAnet and 2786 NA-ACCORD patients initiating ART. CCASAnet patients were younger (median 35 vs. 37 years), more likely to be female (27% vs. 20%) and had lower nadir CD4 count (median 148 vs. 195 cells/µL, p<0.001 for all). In multivariable analyses, CCASAnet patients had a higher risk of mortality after ART initiation (adjusted hazard ratio (AHR) 1.61; 95% confidence interval (CI): 1.32 to 1.96), particularly during the first year, but a lower hazard of treatment interruption (AHR: 0.46; 95% CI: 0.42 to 0.50), change to second-line ART (AHR: 0.56; 95% CI: 0.51 to 0.62) and virologic failure (AHR: 0.52; 95% CI: 0.48 to 0.57).

conclusionsHIV-positive Latinos initiating ART in Latin America have greater continuity of treatment but are at higher risk of death than Latinos in North America. Factors underlying these differences, such as HIV testing, linkage and access to care, warrant further investigation.

Indexed as

AdultAnti-HIV AgentsCanadaFemaleHispanic or LatinoHIV InfectionsHumansMaleNorth AmericaProportional Hazards ModelsSouth AmericaTreatment OutcomeUnited StatesAnti-HIV Agentsantiretroviral therapycohort studieshighly activeHIVLatin AmericamortalityNorth America

Identifiers

PMID26996992
PMCPMC4800379
OpenAlexW2298985434

What OpenQuestion holds

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Registered trials

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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.