ArticleJournal of acquired immune deficiency syndromes (1999)2017
Brief Report: Appraising Viral Load Thresholds and Adherence Support Recommendations in the World Health Organization Guidelines for Detection and Management of Virologic Failure.
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 16 papers, 2 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
16 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Pooled it
- HIV viral resuppression following an elevated viral load: a systematic review and meta-analysis.Journal of the International AIDS Society · 2019Pooled it
- Water Insecurity is Associated with Lack of Viral Suppression and Greater Odds of AIDS-Defining Illnesses Among Adults with HIV in Western Kenya.AIDS and behavior · 2022Trial
- The urgent need for newer drugs in routine HIV treatment in Africa: the case of Ghana.Frontiers in epidemiology · 2025Review
- Article
- Migration in Namibia and its association with HIV acquisition and treatment outcomes.PloS one · 2021Article
- Urgent need to improve programmatic management of patients with HIV failing first-line antiretroviral therapy.Public health action · 2020Article
- Increased Mortality With Delayed and Missed Switch to Second-Line Antiretroviral Therapy in South Africa.Journal of acquired immune deficiency syndromes (1999) · 2020Article
- Virological suppression and clinical management in response to viremia in South African HIV treatment program: A multicenter cohort study.PLoS medicine · 2020Article
- HIV-1 re-suppression on a first-line regimen despite the presence of phenotypic drug resistance.PloS one · 2020Article
- High failure rates of protease inhibitor-based antiretroviral treatment in rural Tanzania - A prospective cohort study.PloS one · 2020Observational
- Determining virological suppression and resuppression by point-of-care viral load testing in a HIV care setting in sub-Saharan Africa.EClinicalMedicine · 2020Article
- Scaling up HIV viral load monitoring in Manicaland, Zimbabwe: challenges and opportunities from the field.Public health action · 2019Article
- Simplifying switch to second-line antiretroviral therapy in sub Saharan Africa: predicted effect of using a single viral load to define efavirenz-based first-line failure.AIDS (London, England) · 2019Article
- Point-of-Care HIV Viral Load Testing: an Essential Tool for a Sustainable Global HIV/AIDS Response.Clinical microbiology reviews · 2019Review
- Risks and Benefits of Dolutegravir- and Efavirenz-Based Strategies for South African Women With HIV of Child-Bearing Potential: A Modeling Study.Annals of internal medicine · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
Abstract
backgroundThe World Health Organization defines HIV virologic failure as 2 consecutive viral loads >1000 copies/mL, measured 3-6 months apart, with interval adherence support. We sought to empirically evaluate these guidelines using data from an observational cohort.
settingThe Uganda AIDS Rural Treatment Outcomes study observed adults with HIV in southwestern Uganda from the time of antiretroviral therapy (ART) initiation and monitored adherence with electronic pill bottles.
methodsWe included participants on ART with a detectable HIV RNA viral load and who remained on the same regimen until the subsequent measurement. We fit logistic regression models with viral resuppression as the outcome of interest and both initial viral load level and average adherence as predictors of interest.
resultsWe analyzed 139 events. Median ART duration was 0.92 years, and 100% were on a nonnucleoside reverse-transcriptase inhibitor-based regimen. Viral resuppression occurred in 88% of those with initial HIV RNA <1000 copies/mL and 42% if HIV RNA was >1000 copies/mL (P <0.001). Adherence after detectable viremia predicted viral resuppression for those with HIV RNA <1000 copies/mL (P = 0.011) but was not associated with resuppression for those with HIV RNA >1000 copies/mL (P = 0.894; interaction term P = 0.077).
conclusionsAmong patients on ART with detectable HIV RNA >1000 copies/mL who remain on the same regimen, only 42% resuppressed at next measurement, and there was no association between interval adherence and viral resuppression. These data support consideration of resistance testing to help guide management of virologic failure in resource-limited settings.
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.