Evidence map›Paper›PMID 32785695›Full record

ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2021

Pretreatment and Acquired Antiretroviral Drug Resistance Among Persons Living With HIV in Four African Countries.

Trevor A Crowell, Brook Danboise, Ajay Parikh, Allahna Esber, Nicole Dear, Peter Coakley, Alex Kasembeli, Jonah Maswai, Samoel Khamadi, Emmanuel Bahemana and 12 more

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

Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
33citing papers in PubMed, 3 pooled it
0.6field-weighted citation impact, top 19% 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

33 citing papers in PubMed, 3 syntheses or guidelines pooled it, 55 citations in OpenAlex.

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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

22 authors at 3 institutions in 2 countries.

Trevor A CrowellUS Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.ORCID 0000-0001-5947-265X
Brook DanboiseUS Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.
Ajay ParikhUS Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.
Allahna EsberUS Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.
Nicole DearUS Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.
Peter CoakleyUS Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.
Alex KasembeliUS Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.
Jonah MaswaiUS Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.
Samoel KhamadiUS Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.
Emmanuel BahemanaUS Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.
Michael IroezinduUS Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.
Francis KiweewaMakerere University Walter Reed Project, Kampala, Uganda.
John OwuothUS Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.
Joanna FreemanUS Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.
Linda L JagodzinskiUS Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.
Jennifer A MaliaUS Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.
Leigh Ann EllerUS Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.
Sodsai TovanabutraUS Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.
Sheila A PeelUS Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.
Julie A AkeUS Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.
Christina S PolyakUS Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.
AFRICOS Study Group
Walter Reed Army Institute of Research · USHenry M. Jackson Foundation · USMakerere University Walter Reed Project · UG

Funding

Military Infectious Disease Research ProgramPEPFARU.S. Department of Defense W81XWH-11-2-0174
6 · The paper itself

Abstract

backgroundEmerging HIV drug resistance (HIVDR) could jeopardize the success of standardized HIV management protocols in resource-limited settings. We characterized HIVDR among antiretroviral therapy (ART)-naive and experienced participants in the African Cohort Study (AFRICOS).

methodsFrom January 2013 to April 2019, adults with HIV-1 RNA >1000 copies/mL underwent ART history review and HIVDR testing upon enrollment at 12 clinics in Uganda, Kenya, Tanzania, and Nigeria. We calculated resistance scores for specific drugs and tallied major mutations to non-nucleoside reverse transcriptase inhibitors (NNRTIs), nucleoside reverse transcriptase inhibitors (NRTIs), and protease inhibitors (PIs) using Stanford HIVDB 8.8 and SmartGene IDNS software. For ART-naive participants, World Health Organization surveillance drug resistance mutations (SDRMs) were noted.

resultsHIVDR testing was performed on 972 participants with median age 35.7 (interquartile range [IQR] 29.7-42.7) years and median CD4 295 (IQR 148-478) cells/mm3. Among 801 ART-naive participants, the prevalence of SDRMs was 11.0%, NNRTI mutations 8.2%, NRTI mutations 4.7%, and PI mutations 0.4%. Among 171 viremic ART-experienced participants, NNRTI mutation prevalence was 83.6%, NRTI 67.8%, and PI 1.8%. There were 90 ART-experienced participants with resistance to both efavirenz and lamivudine, 33 (36.7%) of whom were still prescribed these drugs. There were 10 with resistance to both tenofovir and lamivudine, 8 (80.0%) of whom were prescribed these drugs.

conclusionsParticipants on failing ART regimens had a high burden of HIVDR that potentially limited the efficacy of standardized first- and second-line regimens. Management strategies that emphasize adherence counseling while delaying ART switch may promote drug resistance and should be reconsidered.

Indexed as

Anti-HIV AgentsHIV-1HIV InfectionsAdultCohort StudiesDrug Resistance, ViralHumansMutationUgandaViral LoadAnti-HIV Agentsacquired immunodeficiency syndromeAfrica South of the Saharadrug resistancepublic health surveillance

Identifiers

PMID32785695
PMCPMC8492117
OpenAlexW3048991776

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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.