Evidence map›Paper›PMID 28914169›Full record

ArticleGlobal health action2017

Development of an algorithm for determination of the likelihood of virological failure in HIV-positive adults receiving antiretroviral therapy in decentralized care.

Anton Reepalu, Taye Tolera Balcha, Sten Skogmar, Per-Erik Isberg, Patrik Medstrand, Per Björkman

Abstract read
In one paragraph

Article in Global health action, 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
–field-weighted citation impact
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

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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.

  1. Trial
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

6 authors.

Anton Reepalua Clinical Infection Medicine, Department of Translational Medicine , Lund University , Malmö , Sweden.ORCID http://orcid.org/0000-0003-1690-8921
Taye Tolera Balchaa Clinical Infection Medicine, Department of Translational Medicine , Lund University , Malmö , Sweden.ORCID http://orcid.org/0000-0001-8882-5936
Sten Skogmara Clinical Infection Medicine, Department of Translational Medicine , Lund University , Malmö , Sweden.ORCID http://orcid.org/0000-0001-9342-7115
Per-Erik Isbergc Department of Statistics , Lund University , Lund , Sweden.
Patrik Medstrandd Clinical Virology, Department of Translational Medicine , Lund University , Malmö , Sweden.ORCID http://orcid.org/0000-0003-4259-8744
Per Björkmana Clinical Infection Medicine, Department of Translational Medicine , Lund University , Malmö , Sweden.ORCID http://orcid.org/0000-0002-3697-9375

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEarly identification of virological failure (VF) limits occurrence and spread of drug-resistant viruses in patients receiving antiretroviral treatment (ART). Viral load (VL) monitoring is therefore recommended, but capacities to comply with this are insufficient in many low-income countries. Clinical algorithms might identify persons at higher likelihood of VF to allocate VL resources.

objectivesWe aimed to construct a VF algorithm (the Viral Load Testing Criteria; VLTC) and compare its performance to the 2013 WHO treatment failure criteria.

methodsSubjects with VL results available 1 year after ART start (n = 494) were identified from a cohort of ART-naïve adults (n = 812), prospectively recruited and followed 2011-2015 at Ethiopian health centres. VF was defined as VL≥1000 copies/mL. Variables recorded at the time of sampling, with potential association with VF, were used to construct the algorithm based on multivariate logistic regression.

resultsFifty-seven individuals (12%) had VF, which was independently associated with CD4 count <350 cells/mm

conclusionsThe VLTC identified subjects at greater likelihood of VF, with higher sensitivity and NPV than the WHO criteria. If external validation confirms this performance, these criteria could be used to allocate limited VL resources. Due to its limited specificity, it cannot be used to determine treatment failure in the absence of a confirmatory viral load.

Indexed as

AlgorithmsAdultAnti-HIV AgentsCD4 Lymphocyte CountEthiopiaFemaleHIV InfectionsHIV SeropositivityHumansMaleMiddle AgedProspective StudiesSensitivity and SpecificityTreatment FailureViral LoadAnti-HIV AgentsCD4 lymphocyte countcriteriaEthiopiaHuman immunodeficiency virusviral load

Identifiers

PMID28914169
PMCPMC5645660

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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.