Evidence map›Paper›PMID 28899162›Full record

ArticleAIDS research and human retroviruses2018

High levels of viral suppression among East African HIV-infected women and men in serodiscordant partnerships initiating antiretroviral therapy with high CD4 counts and during pregnancy.

Andrew Mujugira, Jared Baeten, Lara Kidoguchi, Jessica Haberer, Connie Celum, Deborah Donnell, Kenneth Ngure, Elizabeth Bukusi, Nelly Mugo, Stephen Asiimwe and 5 more

Abstract read
In one paragraph

Article in AIDS research and human retroviruses, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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0cells of the map it votes in
2citing papers in PubMed
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1 · What the graph read from it

What it found

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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

2 citing papers in PubMed.

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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

15 authors.

Andrew MujugiraUniversity of Washington, Department of Global Health , 901 Boren Ave , Suite 1300 , Seattle, Washington, United States , 98104 ; mujugira@uw.edu.
Jared BaetenSeattle, United States ; jbaeten@uw.edu.
Lara KidoguchiSeattle, United States ; larakid@uw.edu.
Jessica HabererBoston, United States ; jhaberer@partners.org.
Connie CelumSeattle, Washington, United States ; ccelum@uw.edu.
Deborah DonnellFred Hutchinson Cancer Research Center, SCHARP/VIDI/PHS , 1100 Fairview Ave N , Seattle, Washington, United States , 98109 ; deborah@scharp.org.
Kenneth NgureNarobi, Kenya ; k_ngure@hotmail.com.
Elizabeth BukusiKenya Medical Research Institute, Nairobi, Kenya ; ebukusi@kemri.org.
Nelly MugoKenya Medical Research Institute, Nairobi, Kenya ; rwamba@uw.edu.
Stephen AsiimweKampala, Uganda ; asiimwes@kcrc.or.ug.
Josephine OdoyoKisumu, Kenya ; orajose@kemri-ucsf.org.
Edna TindimwebwaKabwohe, Uganda ; tedna@kcrc.or.ug.
Nulu BulyaKampala, Uganda ; nbulya@yahoo.com.
Elly KatabiraMakerere University, Infectious Disease Institute, Kampala, Uganda ; katabira@imul.com.
Renee HeffronUniversity of Washington, Department of Epidemiology, Seattle, United States ; rheffron@uw.edu.

Funding

University of Washington/Fred Hutch Center for AIDS ResearchP30AI027757 · NIAID · UNIVERSITY OF WASHINGTON · PI EDWIN ROBERTO ORELLANA · 1988 to 2026
$104.9M
Optimizing Antiretroviral-Based HIV Prevention for HIV Serodiscordant CouplesR01MH095507 · NIMH · UNIVERSITY OF WASHINGTON · PI BAETEN, JARED · 2011 to 2020
$6.1M
NIAID NIH HHS P30 AI027757NIMH NIH HHS R01 MH095507
6 · The paper itself

Abstract

backgroundPeople who are asymptomatic and feel healthy, including pregnant women, may be less motivated to initiate ART or achieve high adherence. We assessed whether ART initiation, and viral suppression 6, 12 and 24-months after ART initiation, were lower in HIV-infected members of serodiscordant couples who initiated during pregnancy or with higher CD4 counts.

methodsWe used data from the Partners Demonstration Project, an open-label study of the delivery of integrated PrEP and ART (at any CD4 count) for HIV prevention among high-risk HIV serodiscordant couples in Kenya and Uganda. Differences in viral suppression (HIV RNA <400 copies/ml) among people initiating ART at different CD4 count levels (≤350, 351-500, and >500 cells/mm3) and during pregnancy were estimated using Poisson regression.

resultsOf 865 HIV-infected participants retained after becoming eligible for ART during study follow-up, 95% initiated ART. Viral suppression 24-months after ART initiation was high overall (97%), and comparable among those initiating ART at CD4 counts >500, 351-500 and ≤350 cells/mm3 (96% vs 97% vs 97%; relative risk [RR] 0.98; 95% CI: 0.93-1.03 for CD4 >500 vs <350 and RR 0.99; 95% CI: (0.93-1.06) for CD4 351-500 vs ≤350). Viral suppression was as likely among women initiating ART primarily to prevent perinatal transmission as ART initiation for other reasons (p=0.9 at 6 months and p=0.5 at 12 months).

conclusionsNearly all HIV-infected partners initiating ART were virally suppressed by 24 months, irrespective of CD4 count or pregnancy status. These findings suggest that people initiating ART at high CD4 counts or due to pregnancy can adhere to ART as well as those starting treatment with symptomatic HIV disease or low CD4 counts.

Identifiers

PMID28899162
PMCPMC5806074

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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.