ArticlePloS one2019
Evaluation of the clinical outcomes of the Test and Treat strategy to implement Treat All in Nigeria: Results from the Nigeria Multi-Center ART Study.
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 3 of them syntheses 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
44 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Systematic review and meta-analysis of retention and disengagement after initiation on antiretroviral therapy in low- and middle-income countries after the introduction of Universal Test and Treat policies.Journal of the International AIDS Society · 2025Pooled it
- Retention in Care Among People Living with HIV in Nigeria: A Systematic Review and Meta-analysis.Journal of research in health sciences · 2024Pooled it
- Attrition one year after starting antiretroviral therapy before and after the programmatic implementation of HIV "Treat All" in Sub-Saharan Africa: a systematic review and meta-analysis.BMC infectious diseases · 2023Pooled it
- Incidence of opportunistic infection among people living with HIV in Rwanda; Does treat all policy matter?BMC infectious diseases · 2026Article
- A Comparative Study of the Profile of Cognitive Impairment and Associated Factors among Subsets of Human Immunodeficiency Virus Patients in a Special Human Immunodeficiency Virus Clinic in South-East Nigeria.Annals of African medicine · 2026Article
- Determinants of loss to follow-up among people living with HIV receiving antiretroviral therapy in a universal test and treat setting: A retrospective cohort study in Nepal.Public health in practice (Oxford, England) · 2025Article
- Determinants of loss to follow-up in HIV care among adults on ART at Adama Hospital Medical College, Ethiopia: a case-control study.BMC infectious diseases · 2025Article
- Evaluation of point-of-care Alere Pima CD4 test for low CD4 cell counts test in Uganda.Scientific reports · 2025Article
- Evaluation of differentiated service delivery models on HIV treatment retention among key populations in Nigeria: a prospective cohort analysis.BMC public health · 2025Article
- Use of machine learning in predicting continuity of HIV treatment in selected Nigerian States.PLOS global public health · 2025Article
- Article
- Re-engagement and retention in HIV care after preventive default tracking in a cohort of HIV-infected patients in rural Malawi: A mixed-methods study.PLOS global public health · 2024Article
- Rapid antiretroviral therapy and treatment outcomes among people living with HIV: exploring the mediating roles of medication adherence.Frontiers in public health · 2024Article
- Changes in access to viral load testing, incidence rates of viral load suppression and rebound following the introduction of the 'universal test and treat' guidelines in Cameroon: A retrospective follow-up analysis.PLOS global public health · 2024Article
- An exploration of multi-level factors affecting routine linkage to HIV care in Zambia's PEPFAR-supported treatment program in the treat all era.PLOS global public health · 2024Article
- Factors associated with viral suppression among adults living with HIV on antiretroviral therapy in Nigeria: Analysis of a population-based survey, 2018.HIV medicine · 2023Article
- Healthcare provider perceptions on the implementation of the universal test-and-treat policy in South Africa: a qualitative inquiry.BMC health services research · 2023Article
- Effect of Test and Treat on clinical outcomes in Nigeria: A national retrospective study.PloS one · 2023Article
- HIV test-and-treat policy improves clinical outcomes in Zambian adults from Southern Province: a multicenter retrospective cohort study.Frontiers in public health · 2023Article
- Universal test and treat in Cameroon: a comparative retrospective analysis of mortality and loss to follow-up before and after a strategic change in approach to HIV care.The Pan African medical journal · 2023Article
Corrections and comments
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Authors and funding
16 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
In December 2016, the Nigerian Federal Ministry of Health updated its HIV guidelines to a Treat All approach, expanding antiretroviral therapy (ART) eligibility to all individuals with HIV infection, regardless of CD4+ cell count, and recommending ART be initiated within two weeks of HIV diagnosis (i.e., the Test and Treat strategy). The Test and Treat policy was first piloted in 32 local government areas (LGAs). The primary objective of this study was to evaluate the clinical outcomes of adult patients initiated on ART within two weeks of HIV diagnosis during this pilot. We conducted a retrospective cohort analysis of patients who initiated ART within two weeks of new HIV diagnosis between October 2015 and September 2016 in eight randomly selected LGAs participating in the Test and Treat pilot study. 2,652 adults were newly diagnosed and initiated on ART within two weeks of HIV diagnosis. Of these patients, 8% had documentation of a 12-month viral load measurement, and 13% had documentation of a six-month viral load measurement. Among Test and Treat patients with a documented viral load, 79% were suppressed (≤400 copies/ml) at six months and 78% were suppressed at 12 months. By 12 months post-ART initiation, 34% of the patients who initiated ART under the Test and Treat strategy were lost to follow-up. The median CD4 cell count among patients initiating ART within two weeks of HIV diagnosis was 323 cells/mm3 (interquartile range, 161-518). While randomized controlled trials have demonstrated that Test and Treat strategies can improve patient retention and increase viral suppression compared to standard of care, these findings indicate that the effectiveness of Test and Treat in some settings may be far lower than the efficacy demonstrated in randomized controlled trials. Significant attention to the way Test and Treat strategies are implemented, monitored, and improved particularly related to early retention, can help expand access to ART for all patients.
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