ArticleTropical medicine & international health : TM & IH2018
Failure to initiate HIV treatment in patients with high CD4 counts: evidence from demographic surveillance in rural South Africa.
Article in Tropical medicine & international health : TM & IH, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 24 citations in OpenAlex.
- Why do people living with HIV not initiate treatment? A systematic review of qualitative evidence from low- and middle-income countries.Social science & medicine (1982) · 2018Pooled it
- The Treatment Ambassador Program: A Highly Acceptable and Feasible Community-Based Peer Intervention for South Africans Living with HIV Who Delay or Discontinue Antiretroviral Therapy.AIDS and behavior · 2021Trial
- Rapid antiretroviral therapy initiation in the Botswana Combination Prevention Project: a quasi-experimental before and after study.The lancet. HIV · 2020Trial
- A Risk Prediction Model to Identify People Living with HIV Who are High-risk for Disengagement from Care after HIV Diagnosis in South Africa.AIDS and behavior · 2024Article
- 'I need time to start antiretroviral therapy': understanding reasons for delayed ART initiation among people diagnosed with HIV in Lusaka, Zambia'.Annals of medicine · 2022Article
- Cohort profile: the South African National Health Laboratory Service (NHLS) National HIV Cohort.BMJ open · 2022Article
- One Pill, Once a Day: Simplified Treatment Regimens and Retention in HIV Care.American journal of epidemiology · 2022Article
- Understanding Repeat Positive HIV Testing in South Africa Under Changing Treatment Guidelines.AIDS and behavior · 2022Article
- Quantifying the gender gap in the HIV care cascade in southern Mozambique: We are missing the men.PloS one · 2021Article
- Predictors of antiretroviral therapy initiation in eThekwini (Durban), South Africa: Findings from a prospective cohort study.PloS one · 2021Article
- Time to Antiretroviral Therapy Initiation and Its Predictors Among Newly Diagnosed HIV-Positive People in Nekemte Town, Western Ethiopia: Claim of Universal Test and Treat.HIV/AIDS (Auckland, N.Z.) · 2021Article
- Beyond the barrier: Female Genital Schistosomiasis as a potential risk factor for HIV-1 acquisition.Acta tropica · 2020Review
- Prevalence and Factors Associated with Delayed Initiation of Antiretroviral Therapy Among People Living with HIV in Nekemte Referral Hospital, Western Ethiopia.HIV/AIDS (Auckland, N.Z.) · 2020Article
- Same-day antiretroviral therapy initiation for HIV-infected adults in South Africa: Analysis of routine data.PloS one · 2020Article
- Effect of eliminating CD4-count thresholds on HIV treatment initiation in South Africa: An empirical modeling study.PloS one · 2017Article
Corrections and comments
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Authors and funding
10 authors at 6 institutions in 4 countries.
Funding
Abstract
objectivesTo assess the relationship between CD4 count at presentation and ART uptake and assess predictors of timely treatment initiation in rural KwaZulu-Natal, South Africa.
methodsWe used Kaplan-Meier and Cox proportional hazards models to assess the association between first CD4 count and time from first CD4 to ART initiation among all adults presenting to the Hlabisa HIV Treatment and Care Programme between August 2011 and December 2012 with treatment-eligible CD4 counts (≤ 350 cells/mm
resultsA total of 4739 patients presented for care with eligible CD4 counts. The proportion initiating ART within six months of diagnosis was 67% (95% CI 63, 71) in patients with CD4 ≤ 50, 59% (0.55, 0.63) in patients with CD4 151-200 and 48% (95% CI 44, 51) in patients with CD4 301-350. The hazard of starting ART fell by 17% (95% CI 14, 20) for every 100-cell increase in baseline CD4 count. Among healthier patients under demographic surveillance (n = 193), observable sociodemographic, economic and geographic predictors did not add discriminatory power beyond CD4 count, age and sex to identify patients at high risk of non-initiation.
conclusionsIndividuals presenting for HIV care at higher CD4 counts were less likely to initiate ART than patients presenting at low CD4 counts. Overall, ART uptake was low. Under new guidelines that establish ART eligibility regardless of CD4 count, patients with high CD4 counts may require additional interventions to encourage treatment initiation.
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