Evidence map›Paper›PMID 31999753›Full record

Trial reportPloS one2020

The impact of short term Antiretroviral Therapy (ART) interruptions on longer term maternal health outcomes-A randomized clinical trial.

Patience Atuhaire, Sean S Brummel, Blandina Theophil Mmbaga, Konstantia Angelidou, Lee Fairlie, Avy Violari, Gerhard Theron, Cornelius Mukuzunga, Sajeeda Mawlana, Mwangelwa Mubiana-Mbewe and 12 more

Open access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.1field-weighted citation impact, top 50% 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

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
  2. 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

22 authors at 11 institutions in 7 countries.

Patience AtuhaireMakerere University -John Hopkins University Research Collaboration (MUJHU CARE LTD) CRS, Kampala, Uganda.ORCID 0000-0002-2662-0756
Sean S BrummelHarvard School of Public Health, Boston, Massachusetts, United States of America.
Blandina Theophil MmbagaKilimanjaro Christian Medical Centre (KCMC), Moshi, Tanzania.
Konstantia AngelidouHarvard School of Public Health, Boston, Massachusetts, United States of America.
Lee FairlieWits RHI Shandukani Research Centre CRS, Johannesburg, South Africa.
Avy ViolariSoweto IMPAACT CRS, Johannesburg, South Africa.
Gerhard TheronFAM-CRU CRS, Cape Town, South Africa.
Cornelius MukuzungaMalawi CRS, Lilongwe, Malawi.
Sajeeda MawlanaDurban Paediatric HIV CRS, Durban, South Africa.
Mwangelwa Mubiana-MbeweGeorge CRS, Lusaka, Zambia.
Megeshinee NaidooUmlazi CRS, Durban, South Africa.
Bonus MakananiBlantyre CRS, Blantyre, Malawi.
Patricia MandimaSt Marys CRS, Harare, Zimbabwe.
Teacler NematadziraSeke North CRS, Harare, Zimbabwe.
Nishi SuryavanshiByramjee Jeejeebhoy Medical College (BJMC) CRS, Pune, India.
Tapiwa MbengeranwaHarare Family Care CRS, Harare, Zimbabwe.
Amy LoftisUNC, Chapel Hill, North Carolina, United States of America.
Michael BasarFrontier Science, Amherst, Massachusetts, United States of America.
Katie McCarthyFHI 360, Durham, North Carolina, United States of America.
Judith S CurrierUCLA center for Clinical AIDS Research and Education, Los Angeles, California, United States of America.
Mary Glenn FowlerDepartments of Pathology and Epidemiology, Johns Hopkins University, Baltimore, Maryland, United States of America.
1077BF/1077FF PROMISE Team
APLA Health · USB. J. Medical College & Sassoon Hospital · INBlantyre Institute for Community Ophthalmology · MWFamily Health International 360 · USFrontier Science & Technology Research Foundation · USJohns Hopkins University · USKilimanjaro Christian Medical Centre · TZMUJHU Research Collaboration · UGNational HIV/AIDS/STI/TB Council · ZMSoweto CTC · ZAUniversity of North Carolina at Chapel Hill · US

Funding

LOC-IMPAACT Leadership GroupPharmacokinetics and Safety of Remdesivir for Treatment of COVID-19 in Pregnant Women in the USUM1AI068632 · NIAID · SOCIAL AND SCIENTIFIC SYSTEMS, INC. · PI Sharon A Nachman · 2011 to 2026
$278.1M
Statistical and Data Management Center-Pediatric,Adolescent, and Maternal CTGUM1AI068616 · NIAID · HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH · PI Sean Scott Brummel, Marlene Ann Cooper · 2011 to 2026
$155.6M
University of North Carolina Global HIV Prevention and Treatment Clinical Trials Unit 2024 SupplementUM1AI069423 · NIAID · UNIV OF NORTH CAROLINA CHAPEL HILL · PI Joseph J Eron, MINA CHRISTINE HOSSEINIPOUR · 2012 to 2026
$71.8M
UCLA AIDS Prevention and Treatment Clinical Trials UnitUM1AI069424 · NIAID · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI Judith S. Currier, RAPHAEL J LANDOVITZ · 2012 to 2026
$51.8M
LC - IMPAACT Leadership GroupUM1AI106716 · NIAID · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI Grace M Aldrovandi · 2014 to 2026
$47.2M
The Malawi Clinical Trials UnitUM1AI069518 · NIAID · JOHNS HOPKINS UNIVERSITY · PI JACKY M JENNINGS, TAHA E TAHA · 2012 to 2026
$43.8M
Soweto Clinical Trials UnitUM1AI069453 · NIAID · WITS HEALTH CONSORTIUM (PTY), LTD · PI Glenda E Gray, Lerato Mohapi · 2012 to 2026
$40.9M
University of KwaZulu-Natal - CAPRISA HIV/AIDS Clinical Trials UnitUM1AI069469 · NIAID · UNIVERSITY OF KWAZULU-NATAL · PI QUARRAISHA ABDOOL KARIM · 2012 to 2026
$36.4M
The Johns Hopkins University - Uganda Clinical Trials UnitUM1AI069530 · NIAID · JOHNS HOPKINS UNIVERSITY · PI MARY Glenn Fowler, Philippa Musoke · 2012 to 2026
$34.8M
Wits HIV Research Group CLINICAL TRIAL UNIT (CTU) reapplicationUM1AI069463 · NIAID · WITS HEALTH CONSORTIUM (PTY), LTD · PI REES, HELEN, SANNE, IAN MATTHIAS · 2012 to 2025
$31.8M
UCLA AIDS Prevention and Treatment Clinical Trials UnitU01AI069424 · NIAID · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI CURRIER, JUDITH S. · 2007 to 2011
$13.9M
Developing appropriate risk reduction interventions for pre-teensR21MH083308 · NIMH · WITS HEALTH CONSORTIUM (PTY), LTD · PI GRAY, GLENDA E, SIKKEMA, KATHLEEN J · 2008 to 2009
$331k
NIAID NIH HHS U01 AI069424NIAID NIH HHS UM1 AI068616NIAID NIH HHS UM1 AI068632NIAID NIH HHS UM1 AI069423NIAID NIH HHS UM1 AI069424NIAID NIH HHS UM1 AI069453NIAID NIH HHS UM1 AI069463NIAID NIH HHS UM1 AI069469NIAID NIH HHS UM1 AI069518NIAID NIH HHS UM1 AI069530NIAID NIH HHS UM1 AI106716NIMH NIH HHS R21 MH083308
6 · The paper itself

Abstract

backgroundGiven well documented challenges faced by pregnant women living with HIV taking lifetime ART, it is critical to understand the impact of short-term ART exposure followed by treatment interruption on maternal health outcomes.

methodsHIV+ breastfeeding (BF) and Formula Feeding (FF) women with CD4 counts > 350 cells/mm3, enrolled in the 1077BF/1077FF PROMISE trial were followed to assess the effect of ART during pregnancy and breastfeeding respectively. The first analysis compared ART use limited to the antepartum period (AP-only) relative to women randomized to Zidovudine. The second analysis included women with no pregnancy combination ART exposure; and compared women randomized to either ART or no ART during postpartum (PP-only). Both analyses included follow-up time beyond breastfeeding period. The primary outcome was progression to AIDS and/or death. Secondary outcomes included adverse events and HIV-related events.

results3490 and 1137 HIV+ women were enrolled from 14 sites in Africa and India from April 2011 through September 2014 in cohort AP-only and PP-only, respectively. Most were Black African (96%); median age was 27 years; 97% were WHO Clinical Stage I; and most had a screening CD4 count ≥500 cells/mm3 (78%). The rate of progression to AIDS and/or death was similar and low across all comparison arms (AP comparison, HR = 1.14, 95%CI (0.44, 2.96), p-value = 0.79). In the PP-only cohort, the rate of WHO stage 2-3 events was lower for women randomized to ART(HR = 0.65, 95% CI 0.42, 1.01, p-value = 0.05).

conclusionThe incidence of AIDS and/or death was low in pregnant/postpartum HIV+ women with highCD4 cell counts for all comparison arms. This provides some reassurance that there were limited consequences for short term ART interruption in this group of asymptomatic HIV+ women during up to 4 years of follow up; and underscores that even short term ART exposure postpartum may reduce the risk of WHO grade 2-3 disease progression.

Indexed as

Antiretroviral Therapy, Highly ActiveMaternal HealthOutcome Assessment, Health CareAdolescentAdultAlgorithmsArea Under CurveFemaleHumansMagnetic Resonance ImagingMiddle AgedModels, BiologicalReproducibility of ResultsROC CurveTime FactorsYoung Adult

Identifiers

PMID31999753
PMCPMC6992010
OpenAlexW3004216136

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Registered trials

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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.