Evidence map›Paper›PMID 32621487›Full record

ArticleThe Journal of nutrition2020

Impaired Hematological Status Increases the Risk of Mortality among HIV-Infected Adults Initiating Antiretroviral Therapy in Tanzania.

Ramadhani A Noor, Ajibola I Abioye, Ellen Hertzmark, Anne M Darling, Said Aboud, Ferdinand M Mugusi, Christopher R Sudfeld, Donna Spiegelman, Wafaie W Fawzi

Registry-linked trialOpen access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Journal of nutrition, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00383669 (Trial of Vitamins in HIV Progression and Transmission), which is not on this map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.9field-weighted citation impact, top 24% 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.

NCT00383669 phase3completednot on this map

Trial of Vitamins in HIV Progression and Transmission (A Trial of Vitamins and HAART in HIV Disease Progression)

TypeinterventionalSponsorHarvard School of Public Health (HSPH)Ran2006 to 2009Enrolled4,012ConditionsHIV InfectionsArmsMultivitamins (including B, C and E), Multivitamins B, C and E
3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 11 citations in OpenAlex.

  1. Observational
  2. Article
  3. Article
  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

9 authors at 3 institutions in 2 countries.

Ramadhani A NoorDepartment of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA.
Ajibola I AbioyeDepartment of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA.
Ellen HertzmarkDepartment of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, USA.
Anne M DarlingDepartment of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, USA.
Said AboudDepartment of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Ferdinand M MugusiDepartment of Internal Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Christopher R SudfeldDepartment of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA.
Donna SpiegelmanDepartment of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA.
Wafaie W FawziDepartment of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA.
Harvard University · USHarvard Global Health Institute · USMuhimbili University of Health and Allied Sciences · TZ

Funding

Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
TRIALS OF VITAMINS IN HIV PROGRESSION AND TRANSMISSIONR01HD032257 · NICHD · HARVARD UNIVERSITY (SCH OF PUBLIC HLTH) · PI FAWZI, WAFAIE W · 1994 to 2009
$5.5M
NCATS NIH HHS UL1 TR001863NICHD NIH HHS R01 HD032257
6 · The paper itself

Abstract

backgroundHematological status may predict HIV disease progression and mortality among adults initiating highly active antiretroviral therapy (HAART).

objectivesWe aimed to examine the relation of anemia and iron status at HAART initiation with survival and morbidity outcomes.

methodsWe conducted a case-cohort study of 570 HIV-infected adults initiating HAART who were enrolled in a trial of multivitamins in Tanzania. Hemoglobin, serum ferritin, and hepcidin concentrations were assessed at HAART initiation and participants were followed up monthly. We adjusted serum ferritin for inflammation using a regression correction method to characterize hematological status. Cox proportional hazards models were used to estimate HRs for mortality and incident clinical outcomes.

resultsWe found an 83% prevalence of anemia, 15% prevalence of iron deficiency anemia, and 66% prevalence of anemia of chronic diseases (ACD). The prevalence of elevated iron was 33% and 19% had iron deficiency (ID). After multivariate adjustment, severe anemia (HR: 2.57; 95% CI: 1.49, 4.45) and ACD (HR: 4.71; 95% CI: 2.91, 7.62) were associated with increased risk of mortality as compared with nonanemic participants. In addition, both ID (HR: 2.65; 95% CI: 1.08, 7.78) and elevated iron (HR: 2.83; 95% CI: 2.10, 3.82) were associated with increased risk of mortality as compared with normal iron concentrations. Severe anemia and elevated iron concentrations were associated with incident wasting and >10% weight loss (P values <0.05).

conclusionsAnemia and both ID and elevated iron were associated with increased mortality among HIV-infected adults initiating HAART. Safety and efficacy studies including anemia etiology, timing of HAART initiation, and dose of iron supplementation among HIV patients appear warranted.This trial was registered at clinicaltrials.gov as NCT00383669.

Indexed as

AdultAnemiaAnti-HIV AgentsAntiretroviral Therapy, Highly ActiveCohort StudiesFemaleHIV InfectionsHumansMaleMiddle AgedRisk FactorsTanzaniaAnti-HIV Agentsanemiaanemia of chronic diseasesHIVinflammationiron deficiencymortality

Identifiers

PMID32621487
PMCPMC7540061
OpenAlexW3039325133

What OpenQuestion holds

Textmetadata
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Registered trials

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.