Evidence map›Paper›PMID 34398239›Full record

ArticleThe Journal of infectious diseases2021

Current and Past Immunodeficiency Are Associated With Higher Hospitalization Rates Among Persons on Virologically Suppressive Antiretroviral Therapy for up to 11 Years.

Thibaut Davy-Mendez, Sonia Napravnik, Joseph J Eron, Stephen R Cole, David van Duin, David A Wohl, Brenna C Hogan, Keri N Althoff, Kelly A Gebo, Richard D Moore and 16 more

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Article in The Journal of infectious diseases, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
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

4 citing papers in PubMed.

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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

26 authors.

Thibaut Davy-MendezGillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.ORCID 0000-0002-8505-9268
Sonia NapravnikGillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Joseph J EronGillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Stephen R ColeGillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
David van DuinSchool of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.ORCID 0000-0003-4784-3227
David A WohlGillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Brenna C HoganBloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA.
Keri N AlthoffBloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA.
Kelly A GeboBloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA.
Richard D MooreBloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA.
Michael J SilverbergKaiser Permanente Northern California, Oakland, California, USA.ORCID 0000-0001-9322-1395
Michael A HorbergKaiser Permanente Mid-Atlantic Permanente Research Institute, Rockville, Maryland, USA.
M John GillSouthern Alberta HIV Clinic, Calgary, Alberta, Canada.
W Christopher MathewsSchool of Medicine, University of California, San Diego, San Diego, California, USA.
Marina B KleinFaculty of Medicine, McGill University, Montreal, Quebec, Canada.
Jonathan A ColasantiSchool of Medicine, Emory University, Atlanta, Georgia, USA.
Timothy R SterlingSchool of Medicine, Vanderbilt University, Nashville, Tennessee, USA.
Angel M MayorSchool of Medicine, Universidad Central del Caribe, Bayamon, Puerto Rico, USA.
Peter F RebeiroSchool of Medicine, Vanderbilt University, Nashville, Tennessee, USA.ORCID 0000-0003-1951-9104
Kate BuchaczDivision of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Jun LiDivision of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Ni Gusti Ayu NandithaFaculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Jennifer E ThorneSchool of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.
Ank NijhawanUniversity of Texas Southwestern Medical Center, Dallas, Texas, USA.
Stephen A BerrySchool of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.
North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) of the International Epidemiology Databases to Evaluate AIDS (IeDEA)

Funding

WOMEN'S HEALTH AGENDAU01AI038858 · NIAID · SOCIAL AND SCIENTIFIC SYSTEMS, INC. · PI BENSON, CONSTANCE ANN · 1996 to 2008
$157.5M
AIDS Clinical Trials Group NetworkU01AI068636 · NIAID · SOCIAL AND SCIENTIFIC SYSTEMS, INC. · PI KURITZKES, DANIEL R. · 2006 to 2010
$147.1M
UCSF CLINICAL AND TRANSLATIONAL SCIENCE INSTITUTEUL1RR024131 · NCRR · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI JOHNSTON, S. CLAIBORNE · 2006 to 2011
$111.2M
University of Washington/Fred Hutch Center for AIDS ResearchP30AI027757 · NIAID · UNIVERSITY OF WASHINGTON · PI CONNIE L CELUM · 1988 to 2026
$104.9M
Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
Unsolicited R24 for the CFAR-Network of Integrated Clinical Sciences, CNICSR24AI067039 · NIAID · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI Michael S. Saag · 2006 to 2026
$99.4M
Virology CoreP30AI027763 · NIAID · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI PETER W HUNT · 1988 to 2026
$93.6M
Virology CoreP30AI027767 · NIAID · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI Renee A. Heffron · 1988 to 2026
$84.1M
STATISTICAL AND DATA MANAGEMENT CENTERU01AI038855 · NIAID · HARVARD UNIVERSITY (SCH OF PUBLIC HLTH) · PI HUGHES, MICHAEL DAVID · 1996 to 2006
$78.1M
Engaging University of California Stakeholders for Biorespository ResearchUL1TR000004 · NCATS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI GRANDIS, JENNIFER RUBIN · 2012 to 2015
$78.0M
Studies of Ocular Complications of AIDS - Coordinating CenterU10EY008057 · NEI · JOHNS HOPKINS UNIVERSITY · PI VAN NATTA, MARK L · 1988 to 2012
$78.0M
Virology, Immunology, and Microbiology CoreP30AI050410 · NIAID · UNIV OF NORTH CAROLINA CHAPEL HILL · PI DAVID M. MARGOLIS · 2001 to 2026
$76.9M
CIHR CBR-86906CIHR CBR-94036CIHR HCP-97105CIHR TGF-96118Intramural NIH HHS Z01 CP010124Intramural NIH HHS Z01 CP010176NCATS NIH HHS KL2 TR000421NCATS NIH HHS UL1 TR000004NCATS NIH HHS UL1 TR000083NCATS NIH HHS UL1 TR001863NCI NIH HHS N01 CP001004NCI NIH HHS N02 CP055504NCRR NIH HHS UL1 RR024131NEI NIH HHS K23 EY013707NEI NIH HHS U10 EY008052NEI NIH HHS U10 EY008057NEI NIH HHS U10 EY008067NHLBI NIH HHS U01 HL146192NHLBI NIH HHS U01 HL146193NHLBI NIH HHS U01 HL146194NHLBI NIH HHS U01 HL146201NHLBI NIH HHS U01 HL146202NHLBI NIH HHS U01 HL146203NHLBI NIH HHS U01 HL146204NHLBI NIH HHS U01 HL146205NHLBI NIH HHS U01 HL146208NHLBI NIH HHS U01 HL146240NHLBI NIH HHS U01 HL146241NHLBI NIH HHS U01 HL146242NHLBI NIH HHS U01 HL146245NHLBI NIH HHS U01 HL146333NIAAA NIH HHS R01 AA016893NIAAA NIH HHS U01 AA013566NIAAA NIH HHS U01 AA020790NIAAA NIH HHS U24 AA020794NIAID NIH HHS F31 AI124794NIAID NIH HHS K01 AI093197NIAID NIH HHS K01 AI131895NIAID NIH HHS K24 AI065298NIAID NIH HHS K24 AI118591NIAID NIH HHS P30 AI027757NIAID NIH HHS P30 AI027763NIAID NIH HHS P30 AI027767NIAID NIH HHS P30 AI036219NIAID NIH HHS P30 AI050409NIAID NIH HHS P30 AI050410NIAID NIH HHS P30 AI094189NIAID NIH HHS P30 AI110527NIAID NIH HHS R24 AI067039NIAID NIH HHS T32 AI007001NIAID NIH HHS U01 AI038855NIAID NIH HHS U01 AI038858NIAID NIH HHS U01 AI068634NIAID NIH HHS U01 AI068636NIAID NIH HHS U01 AI069432NIAID NIH HHS U01 AI069434NIAID NIH HHS U01 AI069918NIA NIH HHS R01 AG053100NIDA NIH HHS F31 DA037788NIDA NIH HHS K24 DA000432NIDA NIH HHS R01 DA011602NIDA NIH HHS R01 DA012568NIDA NIH HHS T32 DA007250NIDA NIH HHS U01 DA036935NIMHD NIH HHS G12 MD007583NIMHD NIH HHS U54 MD007587NIMH NIH HHS P30 MH062246
6 · The paper itself

Abstract

backgroundPersons with human immunodeficiency virus (PWH) with persistently low CD4 counts despite efficacious antiretroviral therapy could have higher hospitalization risk.

methodsIn 6 US and Canadian clinical cohorts, PWH with virologic suppression for ≥1 year in 2005-2015 were followed until virologic failure, loss to follow-up, death, or study end. Stratified by early (years 2-5) and long-term (years 6-11) suppression and lowest presuppression CD4 count <200 and ≥200 cells/µL, Poisson regression models estimated hospitalization incidence rate ratios (aIRRs) comparing patients by time-updated CD4 count category, adjusted for cohort, age, gender, calendar year, suppression duration, and lowest presuppression CD4 count.

resultsThe 6997 included patients (19 980 person-years) were 81% cisgender men and 40% white. Among patients with lowest presuppression CD4 count <200 cells/μL (44%), patients with current CD4 count 200-350 vs >500 cells/μL had aIRRs of 1.44 during early suppression (95% confidence interval [CI], 1.01-2.06), and 1.67 (95% CI, 1.03-2.72) during long-term suppression. Among patients with lowest presuppression CD4 count ≥200 (56%), patients with current CD4 351-500 vs >500 cells/μL had an aIRR of 1.22 (95% CI, .93-1.60) during early suppression and 2.09 (95% CI, 1.18-3.70) during long-term suppression.

conclusionsVirologically suppressed patients with lower CD4 counts experienced higher hospitalization rates and could potentially benefit from targeted clinical management strategies.

Indexed as

HIV InfectionsAnti-HIV AgentsCanadaCD4 Lymphocyte CountCohort StudiesFemaleHospitalizationHumansMaleViral LoadAnti-HIV AgentsCD4 lymphocyte countcohort studiesHIVhospitalizationsustained virologic response

Identifiers

PMID34398239
PMCPMC8366443

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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.