Evidence map›Paper›PMID 29373687›Full record

Trial reportJournal of the Pediatric Infectious Diseases Society2018

Substituting Abacavir for Stavudine in Children Who Are Virally Suppressed Without Lipodystrophy: Randomized Clinical Trial in Johannesburg, South Africa.

Renate Strehlau, Stephanie Shiau, Stephen Arpadi, Faeezah Patel, Francoise Pinillos, Wei-Yann Tsai, Ashraf Coovadia, Elaine Abrams, Louise Kuhn

Open access · bronzeAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Journal of the Pediatric Infectious Diseases Society, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact, top 71% of its field
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

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 2 citations in OpenAlex.

  1. Pooled it
  2. Health-Related Physical Fitness Evaluation in HIV-Diagnosed Children and Adolescents: A Scoping Review.International journal of environmental research and public health · 2024
    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

9 authors at 2 institutions in 4 countries.

Renate StrehlauEmpilweni Services and Research Unit, Rahima Moosa Mother and Child Hospital, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, South Africa.
Stephanie ShiauGertrude H. Sergievsky Center, Columbia University.
Stephen ArpadiGertrude H. Sergievsky Center, Columbia University.
Faeezah PatelEmpilweni Services and Research Unit, Rahima Moosa Mother and Child Hospital, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, South Africa.
Francoise PinillosEmpilweni Services and Research Unit, Rahima Moosa Mother and Child Hospital, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, South Africa.
Wei-Yann TsaiDepartment of Pediatrics, College of Physicians and Surgeons, Columbia University.
Ashraf CoovadiaEmpilweni Services and Research Unit, Rahima Moosa Mother and Child Hospital, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, South Africa.
Elaine AbramsDepartment of Epidemiology, Columbia University.
Louise KuhnGertrude H. Sergievsky Center, Columbia University.
Columbia University · USUniversity of the Witwatersrand · ZA

Funding

Host epigenetic and mitochondrial function in HIV-infected childrenR01HD073952 · NICHD · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI KUHN, LOUISE · 2012 to 2016
$3.7M
NICHD NIH HHS R01 HD073952
6 · The paper itself

Abstract

objectivesAbacavir has replaced stavudine in antiretroviral therapy (ART) regimens because it has largely been phased out as a result of toxicity concerns; this loss has reduced further the already-limited drug options for children. Few data regarding virologic and metabolic outcomes among children who undergo substitution of stavudine exist. We evaluated the effects of preemptive substitution of abacavir for stavudine in children initially without lipodystrophy and virally suppressed on a stavudine-containing regimen.

methodsAt Rahima Moosa Mother and Child Hospital in Johannesburg, South Africa, virally suppressed human immunodeficiency virus (HIV)-infected children ≥36 months of age without lipodystrophy were randomly assigned to continue taking stavudine as part of their ART regimen (n = 106) or to have abacavir substituted for stavudine (n = 107). The children were followed for 56 weeks after randomization in the context of a larger trial of treatment options for ART-experienced children.

resultsThe mean age of the children was 4.3 years, and the mean duration of ART before random assignment was 3.5 years. No differences in virological outcomes, CD4 response, growth, or dyslipidemia were noted between the stavudine and abacavir groups. By 56 weeks, children in the abacavir group had less clinically detected lipodystrophy (4.7% vs 16%, respectively), a higher proportion of leg fat relative to total fat (0.243 vs 0.230, respectively; P = .006), and a lower trunk/leg-skinfold ratio (0.547 vs 0.569, respectively; P = .003) than the children in the stavudine group.

conclusionSubstituting abacavir for stavudine did not compromise virological response to treatment and was associated with significantly less lipodystrophy. These results support recommendations that favor abacavir in this population.

Indexed as

Drug SubstitutionViral LoadAbacavirAnthropometryAnti-HIV AgentsBody CompositionCD4 Lymphocyte CountChild, PreschoolDideoxynucleosidesDrug Therapy, CombinationFemaleFollow-Up StudiesHIV InfectionsHumansInfantLipodystrophyAbacavirAnti-HIV AgentsDideoxynucleosidesStavudine

Identifiers

PMID29373687
PMCPMC6097575
OpenAlexW2792569396

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.