Evidence map›Paper›PMID 29956882›Full record

ArticleJournal of the International AIDS Society2018

Sex-based differences in antiretroviral therapy initiation, switching and treatment interruptions: global overview from the International Epidemiologic Databases to Evaluate AIDS (IeDEA).

Michelle L Giles, Amit C Achhra, Alison G Abraham, Andreas D Haas, Michael John Gill, Man Po Lee, Marco Luque, Catherine McGowan, Morna Cornell, Paula Braitstein and 4 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the International AIDS Society, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed
–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

16 citing papers in PubMed.

  1. Observational
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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

14 authors.

Michelle L GilesDepartment of Infectious Diseases, Monash University and Alfred Health, Melbourne, VIC, Australia.
Amit C AchhraKirby Institute, UNSW, Sydney, Australia.
Alison G AbrahamJohn Hopkins School of Medicine, Baltimore, MA, USA.
Andreas D HaasUniversity of Bern, Bern, Switzerland.
Michael John GillUniversity of Calgary, Calgary, AB, Canada.
Man Po LeeQueen Elizabeth Hospital, Hong Kong, China.
Marco LuqueHospital Escuela Universitario, Tegucigalpa, Honduras.
Catherine McGowanVanderbilt University, Nashville, TN, USA.
Morna CornellCentre for Infectious Disease Epidemiology, and Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
Paula BraitsteinUniversity of Toronto, Toronto, ON, Canada.
Nathalie de RekeneireUniversity of Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, Team IDLIC, Bordeaux, France.
Renaud BecquetUniversity of Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, Team IDLIC, Bordeaux, France.
Kara Wools-KaloustianIndiana University School of Medicine, Indianapolis, IN, USA.
Matthew LawKirby Institute, UNSW, Sydney, Australia.

Funding

WOMEN'S HEALTH AGENDAU01AI038858 · NIAID · SOCIAL AND SCIENTIFIC SYSTEMS, INC. · PI BENSON, CONSTANCE ANN · 1996 to 2008
$157.5M
AIDS Clinical Trials Group NetworkU01AI068636 · NIAID · SOCIAL AND SCIENTIFIC SYSTEMS, INC. · PI KURITZKES, DANIEL R. · 2006 to 2010
$147.1M
UCSF CLINICAL AND TRANSLATIONAL SCIENCE INSTITUTEUL1RR024131 · NCRR · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI JOHNSTON, S. CLAIBORNE · 2006 to 2011
$111.2M
University of Washington/Fred Hutch Center for AIDS ResearchP30AI027757 · NIAID · UNIVERSITY OF WASHINGTON · PI EDWIN ROBERTO ORELLANA · 1988 to 2026
$104.9M
Unsolicited R24 for the CFAR-Network of Integrated Clinical Sciences, CNICSR24AI067039 · NIAID · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI Michael S. Saag · 2006 to 2026
$99.4M
Virology CoreP30AI027763 · NIAID · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI MALLORY O JOHNSON · 1988 to 2026
$93.6M
Implementing a Maternal health and PRegnancy Outcomes Vision for Everyone (IMPROVE)UL1TR002378 · NCATS · EMORY UNIVERSITY · PI Andres J Garcia, Elizabeth O. Ofili · 2017 to 2026
$92.1M
Virology CoreP30AI027767 · NIAID · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI Latesha Ellen Elopre · 1988 to 2026
$84.1M
STATISTICAL AND DATA MANAGEMENT CENTERU01AI038855 · NIAID · HARVARD UNIVERSITY (SCH OF PUBLIC HLTH) · PI HUGHES, MICHAEL DAVID · 1996 to 2006
$78.1M
Engaging University of California Stakeholders for Biorespository ResearchUL1TR000004 · NCATS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI GRANDIS, JENNIFER RUBIN · 2012 to 2015
$78.0M
Studies of Ocular Complications of AIDS - Coordinating CenterU10EY008057 · NEI · JOHNS HOPKINS UNIVERSITY · PI VAN NATTA, MARK L · 1988 to 2012
$78.0M
Virology, Immunology, and Microbiology CoreP30AI050410 · NIAID · UNIV OF NORTH CAROLINA CHAPEL HILL · PI DAVID M. MARGOLIS · 2001 to 2026
$76.9M
Intramural NIH HHS Z01 CP010176NCATS NIH HHS KL2 TR000421NCATS NIH HHS UL1 TR000004NCATS NIH HHS UL1 TR000083NCATS NIH HHS UL1 TR000454NCATS NIH HHS UL1 TR002378NCI NIH HHS N02 CP055504NCI NIH HHS N02CP55504NCI NIH HHS R01 CA165937NCI NIH HHS Z01 CP010176NCRR NIH HHS M01 RR000052NCRR NIH HHS UL1 RR024131NEI NIH HHS K23 EY013707NEI NIH HHS U10 EY008052NEI NIH HHS U10 EY008057NEI NIH HHS U10 EY008067NIAAA NIH HHS R01 AA016893NIAAA NIH HHS U01 AA013566NIAAA NIH HHS U01 AA020790NIAAA NIH HHS U24 AA020794NIAID NIH HHS K01 AI093197NIAID NIH HHS K24 AI065298NIAID NIH HHS P30 AI027757NIAID NIH HHS P30 AI027763NIAID NIH HHS P30 AI027767NIAID NIH HHS P30 AI036219NIAID NIH HHS P30 AI050410NIAID NIH HHS P30 AI094189NIAID NIH HHS P30 AI110527NIAID NIH HHS R24 AI067039NIAID NIH HHS U01 AI031834NIAID NIH HHS U01 AI034989NIAID NIH HHS U01 AI034993NIAID NIH HHS U01 AI034994NIAID NIH HHS U01 AI035004NIAID NIH HHS U01 AI035039NIAID NIH HHS U01 AI035040NIAID NIH HHS U01 AI035041NIAID NIH HHS U01 AI035042NIAID NIH HHS U01 AI037613NIAID NIH HHS U01 AI037984NIAID NIH HHS U01 AI038855NIAID NIH HHS U01 AI038858NIAID NIH HHS U01 AI042590NIAID NIH HHS U01 AI068634NIAID NIH HHS U01 AI068636NIAID NIH HHS U01 AI069432NIAID NIH HHS U01 AI069434NIAID NIH HHS U01 AI069907NIAID NIH HHS U01 AI069911NIAID NIH HHS U01 AI069918NIAID NIH HHS U01 AI069919NIAID NIH HHS U01 AI069923NIAID NIH HHS U01 AI069924NIAID NIH HHS U01 AI103390NIAID NIH HHS U01 AI103397NIAID NIH HHS U01 AI103401NIAID NIH HHS U01 AI103408NIAID NIH HHS UM1 AI035043NICHD NIH HHS U01 HD032632NIDA NIH HHS F31 DA037788NIDA NIH HHS K24 DA000432NIDA NIH HHS R01 DA004334NIDA NIH HHS R01 DA011602NIDA NIH HHS R01 DA012568NIDA NIH HHS U01 DA036935NIMHD NIH HHS G12 MD007583NIMHD NIH HHS U54 MD007587NIMH NIH HHS P30 MH062246
6 · The paper itself

Abstract

introductionIn 2015, the World Health Organization recommended that all HIV-infected individuals consider ART initiation as soon as possible after diagnosis. Sex differences in choice of initial ART regimen, indications for switching, time to switching and choice of second-line regimens have not been well described. The aims of this study were to describe first-line ART and CD4 count at ART initiation by sex, calendar year and region, and to analyse time to change or interruption in first-line ART, according to sex in each region.

methodsParticipating cohorts included: Southern, East and West Africa (IeDEA-Africa), North America (NA-ACCORD), Caribbean, Central/South America (CCASAnet) and Asia-Pacific including Australia (IeDEA Asia-Pacific). The primary outcomes analysed for each region and according to sex were choice of initial ART, time to switching and time to discontinuation of the first-line regimen. RESULTS AND DISCUSSION: The combined cohort data set comprised of 715,252 participants across seven regions from low- to high-income settings. The median CD4 count at treatment initiation was lower in men compared with women in nearly all regions and time periods. Women from North America and Southern Africa were more likely to switch ART compared to men (p < 0.001) with approximately 90% of women reporting a major change after 10 years in North America. Overall, after 8 years on ART, >50% of HIV- positive men and women from Southern Africa, East Africa, South and Central America remained on their original regimen. Men were more likely to have a treatment interruption compared with women in low- and middle-income countries from the Asia/Pacific region (p < 0.001) as were men from Southern Africa (p < 0.001). Greater than 75% of men and women did not report a treatment interruption after 10 years on ART from all regions except North America and Southern Africa.

conclusionsThere are regional variations in the ART regimen commenced at baseline and rates of major change and treatment interruption according to sex. Some of this is likely to reflect changes in local and international antiretroviral guideline recommendations but other sex-specific factors such as pregnancy may contribute to these differences.

Indexed as

AdultAnti-HIV AgentsCD4 Lymphocyte CountCohort StudiesDatabases, FactualFemaleHIV InfectionsHumansMaleMiddle AgedSex CharacteristicsTime FactorsAnti-HIV Agentscohort studiesgenderHIVsextreatmentwomen

Identifiers

PMID29956882
PMCPMC6024257

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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.