Evidence map›Paper›PMID 28937991›Full record

ArticlePloS one2017

Sociodemographic correlates of HIV drug resistance and access to drug resistance testing in British Columbia, Canada.

Genevieve Rocheleau, Conrado Franco-Villalobos, Natalia Oliveira, Zabrina L Brumme, Melanie Rusch, Jeannie Shoveller, Chanson J Brumme, P Richard Harrigan

Abstract 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 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–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

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

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Antiretroviral resistance testing in HIV-positive people.The Cochrane database of systematic reviews · 2018
    Pooled it
  2. Article
  3. Article
  4. 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

8 authors.

Genevieve RocheleauDepartment of Medicine, University of British Columbia, Vancouver, Canada.ORCID http://orcid.org/0000-0003-4347-8015
Conrado Franco-VillalobosBC Centre for Excellence in HIV/AIDS, Vancouver, Canada.
Natalia OliveiraBC Centre for Excellence in HIV/AIDS, Vancouver, Canada.
Zabrina L BrummeBC Centre for Excellence in HIV/AIDS, Vancouver, Canada.
Melanie RuschVancouver Island Health Authority, Victoria, Canada.
Jeannie ShovellerBC Centre for Excellence in HIV/AIDS, Vancouver, Canada.
Chanson J BrummeBC Centre for Excellence in HIV/AIDS, Vancouver, Canada.
P Richard HarriganDepartment of Medicine, University of British Columbia, Vancouver, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Sociodemographic correlates of engagement in human immunodeficiency virus (HIV) care are well studied, however the association with accessing drug resistance testing (DRT) and the development of drug resistance have not been characterized. Between 1996-2014, 11 801 HIV patients accessing therapy in British Columbia were observed longitudinally. A subset of 9456 patients had testable viral load; of these 8398 were linked to census data. Sociodemographic (census tract-level) and clinical (individual-level) correlates of DRT were assessed using multivariable General Estimating Equation logistic regression adjusted odds ratios (aOR). The mean number of tests per patient was 2.1 (Q1-Q3; 0-3). Separately, any drug resistance was determined using IAS-USA (2013) list for 5703 initially treatment naïve patients without baseline resistance; 5175 were census-linked (mean of 1.5 protease-reverse transcriptase sequences/patient, Q1-Q3; 0-2). Correlates of detecting drug resistance in this subset were analyzed using Cox PH regression adjusted hazard ratios (aHR). Our results indicate baseline CD4 <200 cells/μL (aOR: 1.5, 1.3-1.6), nRTI-only baseline regimens (aOR: 1.4, 1.3-1.6), and unknown (therapy initiation before routine pVL in BC) baseline pVL (aOR: 1.8, 1.5-2.1) were among individual-level clinical covariates strongly associated with having accessed DRT; while imperfect adherence (aHR: 2.2, 1.9-2.5), low baseline CD4 count (aHR: 1.9, 1.6-2.3), and high baseline pVL (aHR: 2.0, 1.6-2.6) were associated with a higher likelihood of developing drug resistance. A higher median income (aOR: 0.83, 0.77-0.89) and higher percentage of those with aboriginal ancestry (aOR: 0.85, 0.76-0.95) were census tract-level sociodemographic covariates associated with decreased access to DRT. Similarly, aboriginal ancestry (aHR: 1.2, 1.1-1.5) was associated with development of drug resistance. In conclusion, clinical covariates continue to be the strongest correlates of development of drug resistance and access to DRT for individuals. Regions of high median income and high aboriginal ancestry were weak census-level sociodemographic indicators of reduced DRT uptake, however high aboriginal ancestry was the only sociodemographic indicator for development of drug resistance.

Indexed as

Drug Resistance, ViralHealthcare DisparitiesAdultAnti-HIV AgentsBritish ColumbiaFemaleFollow-Up StudiesHealth Services AccessibilityHIV InfectionsHumansLogistic ModelsLongitudinal StudiesMaleMedication AdherenceMiddle AgedMultivariate AnalysisAnti-HIV Agents

Identifiers

PMID28937991
PMCPMC5609746

What OpenQuestion holds

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Registered trials

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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.