Evidence map›Paper›PMID 33745490›Full record

ArticleEpidemiology and infection2021

High rate of loss to follow-up and virological non-suppression in HIV-infected children on antiretroviral therapy highlights the need to improve quality of care in South Africa.

Geneviève A F S van Liere, Rivka Lilian, Jackie Dunlop, Carol Tait, Kate Rees, Moya Mabitsi, Lucy Ranoto, Helen E Struthers, James A McIntyre, Remco P H Peters

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

Article in Epidemiology and infection, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 3 pooled it
1.6field-weighted citation impact, top 14% 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

18 citing papers in PubMed, 3 syntheses or guidelines pooled it, 29 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

10 authors at 4 institutions in 2 countries.

Geneviève A F S van LiereAnova Health Institute, Johannesburg, South Africa.ORCID 0000-0002-9286-4548
Rivka LilianAnova Health Institute, Johannesburg, South Africa.
Jackie DunlopAnova Health Institute, Johannesburg, South Africa.
Carol TaitAnova Health Institute, Johannesburg, South Africa.
Kate ReesAnova Health Institute, Johannesburg, South Africa.
Moya MabitsiAnova Health Institute, Johannesburg, South Africa.
Lucy RanotoAnova Health Institute, Johannesburg, South Africa.
Helen E StruthersAnova Health Institute, Johannesburg, South Africa.
James A McIntyreAnova Health Institute, Johannesburg, South Africa.
Remco P H PetersAnova Health Institute, Johannesburg, South Africa.
Anova Health Institute · ZAUniversity of the Witwatersrand · ZAUniversity of Cape Town · ZAMaastricht University Medical Centre · NL

Funding

PEPFAR 674-A-12-00015
6 · The paper itself

Abstract

Provision of high-quality care and ensuring retention of children on antiretroviral therapy (ART) are essential to reduce human immunodeficiency virus (HIV)-associated morbidity and mortality. Virological non-suppression (≥1000 viral copies/ml) is an indication of suboptimal HIV care and support. This retrospective cohort study included ART-naïve children who initiated first-line ART between July 2015 and August 2017 in Johannesburg and rural Mopani district. Of 2739 children started on ART, 29.5% (807/2739) were lost to care at the point of analysis in August 2018. Among retained children, overall virological non-suppression was 30.2% (469/1554). Virological non-suppression was associated with higher loss to care 30.3% (229/755) compared with suppressed children (9.7%, 136/1399, P < 0.001). Receiving treatment in Mopani was associated with virological non-suppression in children under 5 years (adjusted odds ratio (aOR) 1.7 (95% confidence interval (CI) 1.1-2.4), 5-9 years (aOR 1.8 (1.1-3.0)) and 10-14 years (aOR 1.9 (1.2-2.8)). Virological non-suppression was associated with lower CD4 count in children 5-9 years (aOR 2.1 (1.1-4.1)) and 10-14 years (aOR 2.1 (1.2-3.8)). Additional factors included a shorter time on ART (<5 years aOR 1.8-3.7 (1.3-8.2)), and male gender (5-9 years, aOR1.5 (1.01-2.3)), and receiving cotrimoxazole prophylaxis (10-14 years aOR 2.0 (1.2-3.6)). In conclusion, virological non-suppression is a factor of subsequent programme loss in both regions, and factors affecting the quality of care need to be addressed to achieve the third UNAIDS 90 in paediatric HIV.

Indexed as

AdolescentAnti-HIV AgentsChildChild, PreschoolFemaleHIV InfectionsHumansInfantLost to Follow-UpMaleQuality of Health CareRetrospective StudiesRisk FactorsSouth AfricaTreatment FailureViral LoadAnti-HIV Agents

Identifiers

PMID33745490
PMCPMC8080219
OpenAlexW3138900749

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.