ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2018
The Continuing Burden of Advanced HIV Disease Over 10 Years of Increasing Antiretroviral Therapy Coverage in South Africa.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 88 papers, 7 of them syntheses that pooled it.
What it found
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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.
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.
Who cites it
88 citing papers in PubMed, 7 syntheses or guidelines pooled it, 137 citations in OpenAlex.
- Antiretroviral Therapy Adherence Interventions in the Era of Universal Test and Treat: A Hybrid Systematic-Narrative Literature Review of Global Evidence.AIDS and behavior · 2026Pooled it
- Pooled it
- Prevalence and trends of advanced HIV disease among antiretroviral therapy-naïve and antiretroviral therapy-experienced patients in South Africa between 2010-2021: a systematic review and meta-analysis.BMC infectious diseases · 2023Pooled it
- The prevalence of laboratory-confirmed Pneumocystis jirovecii in HIV-infected adults in Africa: A systematic review and meta-analysis.Medical mycology · 2021Pooled it
- Equity in clinical trials for HIV-associated cryptococcal meningitis: A systematic review of global representation and inclusion of patients and researchers.PLoS neglected tropical diseases · 2021Pooled it
- Cryptococcal Antigen in Serum and Cerebrospinal Fluid for Detecting Cryptococcal Meningitis in Adults Living With Human Immunodeficiency Virus: Systematic Review and Meta-Analysis of Diagnostic Test Accuracy Studies.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Pooled it
- CD4 Cell Count Threshold for Cryptococcal Antigen Screening of HIV-Infected Individuals: A Systematic Review and Meta-analysis.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2018Pooled it
- Single-Dose Liposomal Amphotericin B Treatment for Cryptococcal Meningitis.The New England journal of medicine · 2022Trial
- Point-of-care CD4 testing: Differentiated care for the most vulnerable.Journal of global health · 2022Trial
- SEARCH Human Immunodeficiency Virus (HIV) Streamlined Treatment Intervention Reduces Mortality at a Population Level in Men With Low CD4 Counts.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Trial
- Outcomes of the Three-month Weekly Isoniazid With Rifapentine (3HP) Versus the Six-month Isoniazid Preventive Therapy (6H) Among People Newly Enrolled in HIV Care in Western Kenya.Open forum infectious diseases · 2026Article
- Endovascular Management of Aneurysmal Subarachnoid Hemorrhage in People Living With HIV: Comparable Outcomes in a High-Prevalence Setting.Neurosurgery practice · 2026Article
- Characteristics of Individuals With Advanced HIV Disease and Risk Factors for Mortality in a Contemporary Cohort in South Africa.Journal of acquired immune deficiency syndromes (1999) · 2026Article
- Retrospective analysis of CD4 trends at district levels in South Africa between 2013 and 2023.Southern African journal of HIV medicine · 2026Article
- Differences in Mortality Between Treatment-Naive and Treatment-Discontinuing Hospitalized Individuals With Advanced HIV Disease: A Comparative Retrospective Study From Mexico City.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025Article
- Dolutegravir rollout for treatment of HIV with a focus on advanced disease and tuberculosis coinfection: findings from rural KwaZulu-Natal, South Africa (2019-2023).AIDS research and therapy · 2025Article
- An integrated support model for lay health care workers to improve clients' retention in HIV care.South African family practice : official journal of the South African Academy of Family Practice/Primary Care · 2025Article
- Clinical impact and cost-effectiveness of the WHO-recommended advanced HIV disease package of care.The Lancet. Global health · 2025Article
- "If your CD4 count lowers, that is when you are similar to a person that is non-existent" A qualitative exploration of perceptions around advanced HIV disease in South Africa.BMC public health · 2025Article
- The need to differentiate at re-engagement: lessons from South Africa and Zimbabwe's re-engagement algorithms.Journal of the International AIDS Society · 2025Article
28 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 7 institutions in 2 countries.
Funding
Abstract
Background: Antiretroviral treatment (ART) has been massively scaled up to decrease human immunodeficiency virus (HIV)-related morbidity, mortality, and HIV transmission. However, despite documented increases in ART coverage, morbidity and mortality have remained substantial. This study describes trends in the numbers and characteristics of patients with very advanced HIV disease in the Western Cape, South Africa. Methods: Annual cross-sectional snapshots of CD4 distributions were described over 10 years, derived from a province-wide cohort of all HIV patients receiving CD4 cell count testing in the public sector. Patients with a first CD4 count <50 cells/µL in each year were characterized with respect to prior CD4 and viral load testing, ART access, and retention in ART care. Results: Patients attending HIV care for the first time initially constituted the largest group of those with CD4 count <50 cells/µL, dropping proportionally over the decade from 60.9% to 26.7%. By contrast, the proportion who were ART experienced increased from 14.3% to 56.7%. In patients with CD4 counts <50 cells/µL in 2016, 51.8% were ART experienced, of whom 76% could be confirmed to be off ART or had recent viremia. More than half who were ART experienced with a CD4 count <50 cells/µL in 2016 were men, compared to approximately one-third of all patients on ART in the same year. Conclusions: Ongoing HIV-associated morbidity now results largely from treatment-experienced patients not being in continuous care or not being fully virologically suppressed. Innovative interventions to retain ART patients in effective care are an essential priority for the ongoing HIV response.
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Registered trials
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.