Evidence map›Paper›PMID 29514239›Full record

ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2018

High Proportions of Patients With Advanced HIV Are Antiretroviral Therapy Experienced: Hospitalization Outcomes From 2 Sub-Saharan African Sites.

Janet Ousley, Aline Aurore Niyibizi, Stephen Wanjala, Alexandra Vandenbulcke, Beatrice Kirubi, Willis Omwoyo, Janthimala Price, Leon Salumu, Elisabeth Szumilin, Sofie Spiers and 9 more

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PubMed Full text at PMC Publisher
In one paragraph

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 57 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
57citing papers in PubMed, 3 pooled it
4.8field-weighted citation impact, top 4% 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

57 citing papers in PubMed, 3 syntheses or guidelines pooled it, 72 citations in OpenAlex.

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  5. 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 · 2021
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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

19 authors at 2 institutions in 2 countries.

Janet OusleyMédecins Sans Frontières, Paris, France.
Aline Aurore NiyibiziMédecins Sans Frontières, Paris, France.
Stephen WanjalaMédecins Sans Frontières, Paris, France.
Alexandra VandenbulckeMédecins Sans Frontières, Paris, France.
Beatrice KirubiMédecins Sans Frontières, Paris, France.
Willis OmwoyoMédecins Sans Frontières, Paris, France.
Janthimala PriceMédecins Sans Frontières, Paris, France.
Leon SalumuMédecins Sans Frontières, Paris, France.
Elisabeth SzumilinMédecins Sans Frontières, Paris, France.
Sofie SpiersMédecins Sans Frontières, Brussels, Belgium.
Gilles van CutsemMédecins Sans Frontières, Brussels, Belgium.
Maria MashakoMédecins Sans Frontières, Brussels, Belgium.
Freddy ManganaMédecins Sans Frontières, Brussels, Belgium.
Ramzia MoudarichirouMédecins Sans Frontières, Brussels, Belgium.
Rebecca HarrisonMédecins Sans Frontières, Brussels, Belgium.
Tony KalwangilaMédecins Sans Frontières, Brussels, Belgium.
Gisele LumowoMédecins Sans Frontières, Brussels, Belgium.
Vincent LambertMédecins Sans Frontières, Brussels, Belgium.
David MamanEpicentre, Paris, France.
Médecins Sans Frontières · BEMédecins Sans Frontières · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Human immunodeficiency virus (HIV) remains an important cause of hospitalization and death in low- and middle- income countries. Yet morbidity and in-hospital mortality patterns remain poorly characterized, with prior antiretroviral therapy (ART) exposure and treatment failure status largely unknown. Methods: We studied HIV-infected inpatients aged ≥13 years from cohorts in Kenya and the Democratic Republic of Congo (DRC), assessing clinical and demographic characteristics and hospitalization outcomes. Kenyan inpatients were prospectively enrolled during hospitalization; identical retrospective data were extracted for Congolese patients meeting the study criteria using routine medical information. Results: Among 338 HIV-infected patients in Kenya and 411 in DRC, 83.7% (95% confidence interval [CI], 79.4%-87.3%) and 97.3% (95% CI, 95.2%-98.5%), were admitted with advanced disease (defined as CD4 <200 cells/µL or World Health Organization stage 3/4 illness). Among inpatients with advanced HIV, 35.4% and 21.7% were ART-naive at admission. Patients under care had a median time of 44.1 (interquartile range [IQR], 18.4-90.5) months and 55.9 (IQR, 28.1-99.6) months on treatment; 17.2% (95% CI, 13.5%-21.6%) and 29.6% (95% CI, 25.4%-34.3%) died, 25.9% (95% CI, 16.0%-39.0%) and 22.5% (95% CI, 15.8%-31.0%) of these within 48 hours. Conclusions: Across 2 diverse clinical contexts in sub-Saharan Africa, advanced HIV inpatients were frequently admitted with low CD4 counts, often failing first-line ART. Earlier identification of treatment failure and rapid switching to second-line ART are needed.

Indexed as

AdolescentAdultAfrica South of the SaharaAnti-HIV AgentsAntiretroviral Therapy, Highly ActiveCD4 Lymphocyte CountCongoFemaleHIV InfectionsHospitalizationHospital MortalityHumansKenyaMaleMiddle AgedProspective StudiesAnti-HIV Agents

Identifiers

PMID29514239
PMCPMC5850537
OpenAlexW2794258284

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.