Evidence map›Paper›PMID 31852025›Full record

Observational studyHIV medicine2020

Early mortality after late initiation of antiretroviral therapy in the TREAT Asia HIV Observational Database (TAHOD) of the International Epidemiologic Databases to Evaluate AIDS (IeDEA) Asia-Pacific.

D Rupasinghe, S Kiertiburanakul, A Kamarulzaman, F Zhang, N Kumarasamy, R Chaiwarith, T P Merati, C D Do, S Khusuwan, A Avihingsanon and 14 more

Open access · greenAbstract readObservational Study
In one paragraph

Observational study in HIV medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
0.7field-weighted citation impact, top 29% 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

8 citing papers in PubMed, 10 citations in OpenAlex.

  1. Global Trends in CD4 Count Measurement and Distribution at First Antiretroviral Treatment Initiation.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025
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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

24 authors at 20 institutions in 13 countries.

D RupasingheThe Kirby Institute, UNSW Sydney, Sydney, NSW, Australia.ORCID 0000-0002-4014-3570
S KiertiburanakulFaculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
A KamarulzamanUniversity Malaya Medical Centre, Kuala Lumpur, Malaysia.
F ZhangBeijing Ditan Hospital, Capital Medical University, Beijing, China.
N KumarasamyCART CRS, Voluntary Health Services, Chennai, India.
R ChaiwarithResearch Institute for Health Sciences, Chiang Mai, Thailand.
T P MeratiFaculty of Medicine Udayana University & Sanglah Hospital, Bali, Indonesia.
C D DoBach Mai Hospital, Hanoi, Vietnam.
S KhusuwanChiangrai Prachanukroh Hospital, Chiang Rai, Thailand.
A AvihingsanonHIV-NAT/Thai Red Cross AIDS Research Centre, Bangkok, Thailand.ORCID 0000-0003-3222-9611
M P LeeQueen Elizabeth Hospital, Hong Kong SAR, China.
P S LyNational Center for HIV/AIDS, Dermatology & STDs, Phnom Penh, Cambodia.
E YunihastutiFaculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia.
K V NguyenNational Hospital for Tropical Diseases, Hanoi, Vietnam.
R DitangcoResearch Institute for Tropical Medicine, Muntinlupa City, Philippines.
Y J ChanTaipei Veterans General Hospital, Taipei, Taiwan.
S PujariInstitute of Infectious Diseases, Pune, India.
O T NgTan Tock Seng Hospital, Singapore City, Singapore.
J Y ChoiDivision of Infectious Diseases, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea.
Blh SimHospital Sungai Buloh, Sungai Buloh, Malaysia.
J TanumaNational Center for Global Health and Medicine, Tokyo, Japan.
S SangleBJ Government Medical College and Sassoon General Hospitals, Pune, India.
J RossTREAT Asia, amfAR-The Foundation for AIDS Research, Bangkok, Thailand.
M LawThe Kirby Institute, UNSW Sydney, Sydney, NSW, Australia.
UNSW Sydney · AUBạch Mai Hospital · VNB. J. Medical College & Sassoon Hospital · INCapital Medical University · CNChiangRai Prachanukroh Hospital · THHIV Netherlands Australia Thailand Research Collaboration · THHospital for Tropical Diseases · VNHospital Sungai Buloh · MYMahidol University · THNational Center for Global Health and Medicine · JPNational Center for HIV/AIDS, Dermatology and STD · KHQueen Elizabeth Hospital · CNResearch Institute for Tropical Medicine · PHSerum Institute of India (India) · INTaipei Veterans General Hospital · TWTan Tock Seng Hospital · SGUdayana University · IDUniversity Malaya Medical Centre · MYUniversity of Indonesia · IDVoluntary Health Services Hospital · IN

Funding

The Asia-Pacific HIV Research CollaborationU01AI069907 · NIAID · FOUNDATION FOR AIDS RESEARCH · PI ANNETTE H SOHN · 2006 to 2026
$44.8M
NIAID NIH HHS U01 AI069907
6 · The paper itself

Abstract

objectivesEarly mortality among those still initiating antiretroviral therapy (ART) with advanced stages of HIV infection in resource-limited settings remains high despite recommendations for universal HIV treatment. We investigated risk factors associated with early mortality in people living with HIV (PLHIV) starting ART at low CD4 levels in the Asia-Pacific.

methodsPLHIV enrolled in the Therapeutics, Research, Education and AIDS Training in Asia (TREAT Asia) HIV Observational Database (TAHOD) who initiated ART with a CD4 count < 100 cells/μL between 2003 and 2018 were included in the study. Early mortality was defined as death within 1 year of ART initiation. PLHIV in follow-up for > 1 year were censored at 12 months. Competing risk regression was used to analyse risk factors with loss to follow-up as a competing risk.

resultsA total of 1813 PLHIV were included in the study, of whom 74% were male. With 73 (4%) deaths, the overall first-year mortality rate was 4.27 per 100 person-years (PY). Thirty-eight deaths (52%) were AIDS-related, 10 (14%) were immune reconstituted inflammatory syndrome (IRIS)-related, 13 (18%) were non-AIDS-related and 12 (16%) had an unknown cause. Risk factors included having a body mass index (BMI) < 18.5 [sub-hazard ratio (SHR) 2.91; 95% confidence interval (CI) 1.60-5.32] compared to BMI 18.5-24.9, and alanine aminotransferase (ALT) ≥ 5 times its upper limit of normal (ULN) (SHR 6.14; 95% CI 1.62-23.20) compared to ALT < 5 times its ULN. A higher CD4 count (51-100 cells/μL: SHR 0.28; 95% CI 0.14-0.55; and > 100 cells/μL: SHR 0.12; 95% CI 0.05-0.26) was associated with reduced hazard for mortality compared to CD4 count ≤ 25 cells/μL.

conclusionsFifty-two per cent of early deaths were AIDS-related. Efforts to initiate ART at CD4 counts > 50 cell/μL are associated with improved short-term survival rates, even in those with late stages of HIV disease.

Indexed as

AdultAlanine TransaminaseAnti-HIV AgentsCause of DeathCD4 Lymphocyte CountFemaleHIV InfectionsHumansMaleMortalityPovertyTime-to-TreatmentAlanine TransaminaseAnti-HIV Agentsadvanced diseaseAsia-PacificHIVmortality

Identifiers

PMID31852025
PMCPMC7299786
OpenAlexW2996143207

What OpenQuestion holds

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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.