Evidence map›Paper›PMID 28182675›Full record

ArticlePloS one2017

Comparing longitudinal CD4 responses to cART among non-perinatally HIV-infected youth versus adults: Results from the HIVRN Cohort.

Allison L Agwu, John A Fleishman, Guy Mahiane, Bareng Aletta Sanny Nonyane, Keri N Althoff, Baligh R Yehia, Stephen A Berry, Richard Rutstein, Ank Nijhawan, Christopher Mathews and 5 more

Open access · goldAbstract read
In one paragraph

Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.3field-weighted citation impact, top 43% 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

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. 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

15 authors at 7 institutions in 1 country.

Allison L AgwuDivision of Pediatric Infectious Diseases, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, United States of America.ORCID http://orcid.org/0000-0002-8449-222X
John A FleishmanCenter for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality, Rockville, MD, United States of America.
Guy MahianeDepartment of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America.
Bareng Aletta Sanny NonyaneDepartment of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America.
Keri N AlthoffBloomberg School of Public Health, Johns Hopkins Medical Institutions, Baltimore, MD, United States of America.
Baligh R YehiaDivision of Infectious Diseases, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA, United States of America.
Stephen A BerryDivision of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, United States of America.
Richard RutsteinDivision of General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, United States of America.
Ank NijhawanDepartment of Internal Medicine, UT Southwestern Medical Center, Parkland Health and Hospital System, Dallas TX, United States of America.
Christopher MathewsDepartment of Medicine, University of California San Diego, San Diego, CA, United States of America.
Judith A AbergDepartment of Medicine, Division of Infectious Diseases, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America.
Jeanne C KerulyDivision of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, United States of America.
Richard D MooreDivision of General Internal Medicine, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, United States of America.
Kelly A GeboDivision of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, United States of America.
HIV Research Network
Johns Hopkins University · USAgency for Healthcare Research and Quality · USChildren's Hospital of Philadelphia · USIcahn School of Medicine at Mount Sinai · USParkland Health & Hospital System · USUniversity of California San Diego · USUniversity of Pennsylvania · US

Funding

Vaccine Response and Immunotherapeutics SWGP30AI094189 · NIAID · JOHNS HOPKINS UNIVERSITY · PI Richard E. Chaisson · 2012 to 2026
$67.0M
Reducing Readmissions and Improving Outcomes in HIV-Infected PatientsK23AI112477 · NIAID · UT SOUTHWESTERN MEDICAL CENTER · PI NIJHAWAN, ANK ELISABETH · 2015 to 2018
$703k
Universal Screening of HIV-Infected Persons for Gonorrhea and ChlamydiaK23AI084854 · NIAID · JOHNS HOPKINS UNIVERSITY · PI BERRY, STEPHEN ARTHUR · 2010 to 2014
$671k
HAART Initiation in Behaviorally HIV-Infected YouthK23AI084549 · NIAID · JOHNS HOPKINS UNIVERSITY · PI AGWU, ALLISON L · 2010 to 2013
$537k
CLINICAL OUTCOMES IN ELDERLY HIV PATIENTSR01AG026250 · NIA · JOHNS HOPKINS UNIVERSITY · PI GEBO, KELLY A · 2006 to 2007
$197k
NIAID NIH HHS K23 AI084549NIAID NIH HHS K23 AI084854NIAID NIH HHS K23 AI112477NIAID NIH HHS P30 AI094189NIA NIH HHS R01 AG026250
6 · The paper itself

Abstract

backgroundYouth have residual thymic tissue and potentially greater capacity for immune reconstitution than adults after initiation of combination antiretroviral therapy (cART). However, youth face behavioral and psychosocial challenges that may make them more likely than adults to delay ART initiation and less likely to attain similar CD4 outcomes after initiating cART. This study compared CD4 outcomes over time following cART initiation between ART-naïve non-perinatally HIV-infected (nPHIV) youth (13-24 years-old) and adults (≥25-44 years-old).

methodsRetrospective analysis of ART-naïve nPHIV individuals 13-44 years-old, who initiated their first cART between 2008 and 2011 at clinical sites in the HIV Research Network. A linear mixed model was used to assess the association between CD4 levels after cART initiation and age (13-24, 25-34, 35-44 years), accounting for random variation within participants and between sites, and adjusting for key variables including gender, race/ethnicity, viral load, gaps in care (defined as > 365 days between CD4 tests), and CD4 levels prior to cART initiation (baseline CD4).

resultsAmong 2,595 individuals (435 youth; 2,160 adults), the median follow-up after cART initiation was 179 weeks (IQR 92-249). Baseline CD4 was higher for youth (320 cells/mm3) than for ages 25-34 (293) or 35-44 (258). At 239 weeks after cART initiation, median unadjusted CD4 was higher for youth than adults (576 vs. 539 and 476 cells/mm3, respectively), but this difference was not significant when baseline CD4 was controlled. Compared to those with baseline CD4 ≤200 cells/mm3, individuals with baseline CD4 of 201-500 and >500 cells/mm3 had greater predicted CD4 levels: 390, 607, and 831, respectively. Additionally, having no gaps in care and higher viral load were associated with better CD4 outcomes.

conclusionsDespite having residual thymic tissue, youth attain similar, not superior, CD4 gains as adults. Early ART initiation with minimal delay is as essential to optimizing outcomes for youth as it is for their adult counterparts.

Indexed as

AdolescentAdultAge FactorsAntiviral AgentsCD4 Lymphocyte CountFemaleHIV InfectionsHumansMaleTreatment OutcomeAntiviral Agents

Identifiers

PMID28182675
PMCPMC5300758
OpenAlexW2587415620

What OpenQuestion holds

Textmetadata
LicenceCC0
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.