Evidence map›Paper›PMID 31810468›Full record

ArticleAIDS research and therapy2019

Antiretroviral concentration measurements as an additional tool to manage virologic failure in resource limited settings: a case control study.

Allan Buzibye, Joseph Musaazi, Amrei von Braun, Sarah Nanzigu, Christine Sekaggya-Wiltshire, Andrew Kambugu, Jan Fehr, Mohammed Lamorde, Ursula Gutteck, Daniel Muller and 3 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in AIDS research and therapy, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
0.3field-weighted citation impact, top 40% 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

7 citing papers in PubMed, 11 citations in OpenAlex.

  1. Article
  2. Article
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  4. Review
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  6. Review
  7. Strategies for Implementation Research to Investigate the Negative Pharmacokinetic Interaction Between Efavirenz and Dolutegravir.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021
    Article
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

13 authors at 7 institutions in 4 countries.

Allan BuzibyeInfectious Diseases Institute, Makerere University, College of Health Sciences, P. O. BOX 22418, Kampala, Uganda. abuzibye@idi.co.ug.
Joseph MusaaziInfectious Diseases Institute, Makerere University, College of Health Sciences, P. O. BOX 22418, Kampala, Uganda.
Amrei von BraunDivision of Infectious Diseases and Tropical Medicine, University Hospital of Leipzig, University of Leipzig, Leipzig, Germany.
Sarah NanziguDepartment of Pharmacology, Makerere University, College of Health Sciences, Kampala, Uganda.
Christine Sekaggya-WiltshireInfectious Diseases Institute, Makerere University, College of Health Sciences, P. O. BOX 22418, Kampala, Uganda.
Andrew KambuguInfectious Diseases Institute, Makerere University, College of Health Sciences, P. O. BOX 22418, Kampala, Uganda.
Jan FehrDepartment of Public Health, University Hospital, University of Zurich, Zurich, Switzerland.
Mohammed LamordeInfectious Diseases Institute, Makerere University, College of Health Sciences, P. O. BOX 22418, Kampala, Uganda.
Ursula GutteckDepartment of Clinical Chemistry, University Hospital, University of Zurich, Zurich, Switzerland.
Daniel MullerDepartment of Clinical Chemistry, University Hospital, University of Zurich, Zurich, Switzerland.
Stefanie SowinskiThe Gladstone Institute of Virology and Immunology, University of California, San Francisco, San Francisco, CA, USA.
Steven J ReynoldsDivision of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA.
Barbara CastelnuovoInfectious Diseases Institute, Makerere University, College of Health Sciences, P. O. BOX 22418, Kampala, Uganda.
Makerere University · UGInfectious Diseases Institute · UGUniversity Hospital of Zurich · CHGladstone Institutes · USJohns Hopkins Medicine · USUniversity Hospital Leipzig · DEUniversity of Zurich · CH

Funding

Virology CoreP30AI027763 · NIAID · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI MALLORY O JOHNSON · 1988 to 2026
$93.6M
National Institutes of Health (NIH), University of California, San Francisco-Gladstone Institute of Virology & Immunology Center for AIDS Research P30-AI027763NIAID NIH HHS P30 AI027763
6 · The paper itself

Abstract

backgroundSeveral studies demonstrate a correlation between sub-therapeutic concentrations of antiretroviral drugs and virologic failure. We examined the sensitivity, specificity and predictive values of sub-therapeutic drug levels in predicting viralogic failure.

methodsThis was a case control study with cases being samples of participants with virologic failure, and controls samples of participants with virologic suppression. We analyzed samples obtained from participants that had been on antiretroviral treatment (ART) for at least 6 months. Virologic failure was defined as HIV-RNA viral load ≥ 1000 copies/ml. Sub-therapeutic drug levels were defined according to published reference cutoffs. The diagnostic validity of drug levels for virologic failure was assessed using plasma viral loads as a gold standard.

resultsSub-therapeutic ART concentrations explained only 38.2% of virologic failure with a probability of experiencing virologic failure of 0.66 in a patient with low drug levels versus 0.25 for participants with measurements within or above the normal range. Approximately 90% of participants with ART concentrations above the lower clinical cut off did not have virologic failure.

conclusionsThese results support prior indication for therapeutic drug monitoring in cases of suspected virologic failure.

Indexed as

Sustained Virologic ResponseAdolescentAdultAnti-Retroviral AgentsCase-Control StudiesDrug MonitoringFemaleHealth ResourcesHIV-1HIV InfectionsHumansMalePredictive Value of TestsRNA, ViralTreatment FailureViral LoadAnti-Retroviral AgentsRNA, ViralHIVResource limited settingTherapeutic drug monitoringUgandaVirologic failure

Identifiers

PMID31810468
PMCPMC6898957
OpenAlexW2993496577

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.