Evidence map›Paper›PMID 31877153›Full record

Observational studyPloS one2019

Comparison of 6-week PMTCT outcomes for HIV-exposed and HIV-unexposed infants in the era of lifelong ART: Results from an observational prospective cohort study.

Appolinaire Tiam, Seble G Kassaye, Rhoderick Machekano, Vincent Tukei, Michelle M Gill, Majoalane Mokone, Mosilinyane Letsie, Mots'oane Tsietso, Irene Seipati, Janety Barasa and 3 more

Open access · goldAbstract readMulticenter StudyObservational Study
In one paragraph

Observational study in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 2 pooled it
0.6field-weighted citation impact, top 32% 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

5 citing papers in PubMed, 2 syntheses or guidelines pooled it, 9 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Review
  4. Article
  5. 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 6 institutions in 3 countries.

Appolinaire TiamElizabeth Glaser Pediatric AIDS Foundation, Washington D.C., United States of America.ORCID 0000-0002-8045-7590
Seble G KassayeDepartment of Medicine Georgetown University School of Medicine, Washington D.C., United States of America.
Rhoderick MachekanoElizabeth Glaser Pediatric AIDS Foundation, Washington D.C., United States of America.
Vincent TukeiElizabeth Glaser Pediatric AIDS Foundation, Maseru, Lesotho.
Michelle M GillElizabeth Glaser Pediatric AIDS Foundation, Washington D.C., United States of America.
Majoalane MokoneElizabeth Glaser Pediatric AIDS Foundation, Maseru, Lesotho.
Mosilinyane LetsieMinistry of Health, Maseru, Lesotho.
Mots'oane TsietsoMinistry of Health, Maseru, Lesotho.
Irene SeipatiMinistry of Health, Maseru, Lesotho.
Janety BarasaElizabeth Glaser Pediatric AIDS Foundation, Maseru, Lesotho.
Anthony IsavwaElizabeth Glaser Pediatric AIDS Foundation, Maseru, Lesotho.
Thorkild TylleskärCentre for International Health, University of Bergen, Bergen, Norway.
Laura GuayElizabeth Glaser Pediatric AIDS Foundation, Washington D.C., United States of America.
Lesotho Planned Parenthood Association · LSElizabeth Glaser Pediatric AIDS Foundation · USMinistry of Health · LSGeorgetown University · USMilken Institute · USUniversity of Bergen · NO

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLifelong antiretroviral therapy (ART) reduces mother-to-child HIV transmission (MTCT) and improves maternal health. Data on the outcomes of HIV-exposed infants (HEI) compared to their unexposed counterparts in the era of universal ART is limited. We compared birth and 6-week outcomes among infants born to HIV-positive and HIV-negative women in Lesotho.

methods941 HIV-negative and 653 HIV-positive pregnant women were enrolled in an observational cohort to evaluate the effectiveness of prevention of mother-to-child HIV transmission (PMTCT) program after implementation of universal maternal ART in 14 health facilities. Pregnancy, delivery, birth, and 6-week data were collected through participant interviews and medical record review. DNA PCR testing for HEI was conducted within 2 weeks of birth and at around 6 weeks of age. Data were analysed to estimate the distribution of birth outcomes, mortality, HIV transmission and HIV-free survival at 6 weeks.

resultsHIV-positive women were older (mean age of 28.7 vs. 24.4 years) and presented for antenatal care earlier (mean gestational age of 23.0 weeks vs 25.3 weeks) than HIV-negative women. Prematurity was more frequent among HEI, 7.8% vs. 3.6%. There was no difference in rates of congenital anomalies between HEI (1.0%) and HIV-unexposed infants (HUI) (0.6%). Cumulative HIV transmission was 0.9% (N = 4/431) (95% CI:0.25-2.36) at birth and 1.0% (N = 6/583) (95% CI:0.38-2.23) at 6 weeks. Overall mortality, including stillbirths, was 5.2% and 6.0% by 6 weeks for HUI and HEI respectively. Among liveborn infants, 6-week HIV-free survival for HEI was 95.6% (95% CI:93.7-97.1) compared to 96.8% (95% CI:95.4-97.9) survival for HUI.

conclusionsImplementation of universal maternal ART lowers MTCT at 6 weeks of age with no differences in congenital anomalies or early mortality between HIV exposed Infants and HIV unexposed infants. However, HIV exposed infants continue to have high rates of prematurity despite improved maternal health on ART.

Indexed as

AdultAnti-HIV AgentsCase-Control StudiesFemaleHIVHIV InfectionsHumansInfantInfant MortalityInfectious Disease Transmission, VerticalLesothoMaternal AgePregnancyPregnancy Complications, InfectiousPremature BirthProspective StudiesAnti-HIV AgentsRNA, Viral

Identifiers

PMID31877153
PMCPMC6932788
OpenAlexW2996818152

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.