ArticleJournal of acquired immune deficiency syndromes (1999)2017
Relationship Between Time to Initiation of Antiretroviral Therapy and Treatment Outcomes: A Cohort Analysis of ART Eligible Adolescents in Zimbabwe.
Article in Journal of acquired immune deficiency syndromes (1999), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 3 of them syntheses that pooled it.
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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.
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Who cites it
13 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Pooled it
- Pooled it
- Rapid initiation of antiretroviral therapy for people living with HIV.The Cochrane database of systematic reviews · 2019Pooled it
- HIV Care Cascade Among Adolescents in a "Test and Treat" Community-Based Intervention: HPTN 071 (PopART) for Youth Study.The Journal of adolescent health : official publication of the Society for Adolescent Medicine · 2021Trial
- Trial
- Gastrointestinal Mucosal Disruptions During ART-Treated SIVPathogens & immunity · 2026Article
- Challenges and Enablers of Antiretroviral Therapy Adherence Among Ethiopian Adolescents: A Qualitative Study.International journal of sexual health : official journal of the World Association for Sexual Health · 2026Article
- Time to initiation of antiretroviral therapy and its predictors among newly diagnosed HIV positive at the selected public health centers in Adama Town, Ethiopia.AIDS research and therapy · 2025Article
- Elevated Inflammation Associated with Markers of Neutrophil Function and Gastrointestinal Disruption in Pilot Study ofViruses · 2024Article
- The effect of late presentation on HIV related mortality among adolescents in public hospitals of north showa zone Oromiya, Ethiopia; 2022: a retrospective cohort study.BMC infectious diseases · 2024Article
- Article
- Simplified clinical algorithm for immediate antiretroviral therapy initiation: The HATI [HIV awal (early) Test & Treat in Indonesia] implementation research in Indonesia.The Indian journal of medical research · 2022Review
- Putting youth at the centre: co-design of a community-based intervention to improve HIV outcomes among youth in Zimbabwe.Wellcome open research · 2022Article
Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
backgroundAge-specific retention challenges make antiretroviral therapy (ART) initiation in adolescents difficult, often requiring a lengthy preparation process. This needs to be balanced against the benefits of starting treatment quickly. The optimal time to initiation duration in adolescents is currently unknown.
objectiveTo assess the effect of time to ART initiation on mortality and loss to follow-up (LTFU) among treatment eligible adolescents.
methodsWe conducted a retrospective cohort analysis among 1499 ART eligible adolescents aged ≥10 to <19 years registered in a public sector HIV program in Bulawayo, Zimbabwe, between 2004 and 2011. Hazard ratios (HR) for mortality and LTFU were calculated for different time to ART durations using multivariate Cox regression models.
resultsMedian follow-up duration was 1.6 years. Mortality HRs of patients who initiated at 0 to ≤7 days, >14 days to ≤1 month, >1 to ≤2 months, >2 months, and before initiation were 1.59, 1.19, 1.56, 1.08, and 0.94, respectively, compared with the reference group of >7 to ≤14 days. LTFU HRs were 1.02, 1.07, 0.85, 0.97, and 3.96, respectively. Among patients not on ART, 88% of deaths and 85% of LTFU occurred during the first 3 months after becoming ART eligible, but only 37% and 29% among adolescents on ART, respectively.
conclusionsNeither mortality or LTFU was associated with varying time to ART. The initiation process can be tailored to the adolescents' needs and individual life situations without risking to increase poor treatment outcomes. Early mortality was high despite rapid ART initiation, calling for earlier rather than faster initiation through HIV testing scale-up.
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