Evidence map›Paper›PMID 31343455›Full record

ArticleJournal of acquired immune deficiency syndromes (1999)2019

Antiretroviral Adherence Level Necessary for HIV Viral Suppression Using Real-World Data.

Kathy K Byrd, John G Hou, Ron Hazen, Heather Kirkham, Sumihiro Suzuki, Patrick G Clay, Tim Bush, Nasima M Camp, Paul J Weidle, Ambrose Delpino and 1 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of acquired immune deficiency syndromes (1999), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 154 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
154citing papers in PubMed, 4 pooled it
–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

154 citing papers in PubMed, 4 syntheses or guidelines pooled it.

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94 more citing papers are in PubMed but not listed here.

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

11 authors.

Kathy K ByrdDivision of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA.
John G HouHealth Analytics, Research, and Reporting Department, Walgreen Co., Deerfield, IL.
Ron HazenHealth Analytics, Research, and Reporting Department, Walgreen Co., Deerfield, IL.
Heather KirkhamHealth Analytics, Research, and Reporting Department, Walgreen Co., Deerfield, IL.
Sumihiro SuzukiDepartment of Biostatistics and Epidemiology, University of North Texas Health Science Center, Fort Worth, TX.
Patrick G ClayDepartment of Pharmacotherapy, University of North Texas Health Science Center System College of Pharmacy, Fort Worth, TX.
Tim BushDivision of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA.
Nasima M CampDepartment of Health, Research, Informatics, and Technology, ICF, Atlanta, GA.
Paul J WeidleDivision of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA.
Ambrose DelpinoPatient Care and Advocacy Department, Walgreen Co., Deerfield, IL.
Patient-Centered HIV Care Model Team

Funding

Improving Retention in Care, Adherence and HIV prevention Behaviors of Minorities with HIV through Medication Therapy Management of HIV Disease in Community PharmaciesU65PS004275 · PS · UNIVERSITY OF NORTH TEXAS HLTH SCI CTR · PI CLAY, PATRICK GERARD · 2013 to 2015
$2.4M
Intramural CDC HHS CC999999NCHHSTP CDC HHS U65 PS004275
6 · The paper itself

Abstract

backgroundA benchmark of near-perfect adherence (≥95%) to antiretroviral therapy (ART) is often cited as necessary for HIV viral suppression. However, given newer, more effective ART medications, the threshold for viral suppression may be lower. We estimated the minimum ART adherence level necessary to achieve viral suppression. SETTINGS: The Patient-centered HIV Care Model demonstration project.

methodsAdherence to ART was calculated using the proportion of days covered measure for the 365-day period before each viral load test result, and grouped into 5 categories (<50%, 50% to <80%, 80% to <85%, 85% to <90%, and ≥90%). Binomial regression analyses were conducted to determine factors associated with viral suppression (HIV RNA <200 copies/mL); demographics, proportion of days covered category, and ART regimen type were explanatory variables. Generalized estimating equations with an exchangeable working correlation matrix accounted for correlation within subjects. In addition, probit regression models were used to estimate adherence levels required to achieve viral suppression in 90% of HIV viral load tests.

resultsThe adjusted odds of viral suppression did not differ between persons with an adherence level of 80% to <85% or 85% to <90% and those with an adherence level of ≥90%. In addition, the overall estimated adherence level necessary to achieve viral suppression in 90% of viral load tests was 82% and varied by regimen type; integrase inhibitor- and nonnucleoside reverse transcriptase inhibitor-based regimens achieved 90% viral suppression with adherence levels of 75% and 78%, respectively.

conclusionsThe ART adherence level necessary to reach HIV viral suppression may be lower than previously thought and may be regimen-dependent.

Indexed as

Medication AdherenceAnti-HIV AgentsAnti-Retroviral AgentsFemaleHIV-1HIV InfectionsHIV Integrase InhibitorsHumansMaleMiddle AgedMultivariate AnalysisRegression AnalysisReverse Transcriptase InhibitorsUnited StatesViral LoadAnti-HIV AgentsAnti-Retroviral AgentsHIV Integrase InhibitorsReverse Transcriptase Inhibitors

Identifiers

PMID31343455
PMCPMC6854523

What OpenQuestion holds

Textmetadata
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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.