Evidence map›Paper›PMID 34399706›Full record

ArticleBMC infectious diseases2021

Adoption of evidence-informed guidelines in prescribing protease inhibitors for HIV-Tuberculosis co-infected patients on rifampicin and effects on HIV treatment outcomes in Uganda.

Frank Mulindwa, Barbara Castelnuovo, Bruce Kirenga, Dennis Kalibbala, Priscilla Haguma, Martin Muddu, Fred C Semitala

Open access · goldAbstract read
In one paragraph

Article in BMC infectious diseases, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.1field-weighted citation impact, top 58% 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

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. 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

7 authors at 3 institutions in 1 country.

Frank MulindwaDepartment of Internal Medicine, Makerere University College of Health Sciences, Kampala, Uganda. mulindwafrank93@gmail.com.
Barbara CastelnuovoMakerere University Infectious Diseases Institute, Kampala, Uganda.
Bruce KirengaDepartment of Internal Medicine, Makerere University College of Health Sciences, Kampala, Uganda.
Dennis KalibbalaMakerere University- John Hopkins University Collaboration, Kampala, Uganda.
Priscilla HagumaDepartment of Internal Medicine, Makerere University College of Health Sciences, Kampala, Uganda.
Martin MudduMakerere University Joint AIDS Program, Kampala, Uganda.
Fred C SemitalaDepartment of Internal Medicine, Makerere University College of Health Sciences, Kampala, Uganda.
Makerere University · UGInfectious Diseases Institute · UGMUJHU Research Collaboration · UG

Funding

HIV Co-infections in Uganda: TB, Cryptococcus, and Viral Hepatitis.D43TW009771 · FIC · JOHNS HOPKINS UNIVERSITY · PI CASTELNUOVO, BARBARA, KAMBUGU, ANDREW DDUNGU · 2014 to 2023
$3.3M
Leveraging existing HIV differentiated service delivery models to screen and treat hypertension in Ugandan persons living with HIV for dual controlK43TW011963 · FIC · INFECTIOUS DISEASES RES COLLABORATION · PI MUDDU, MARTIN · 2021 to 2025
$667k
FIC NIH HHS D43 TW009771FIC NIH HHS K43 TW011963
6 · The paper itself

Abstract

backgroundWe aimed to determine how emerging evidence over the past decade informed how Ugandan HIV clinicians prescribed protease inhibitors (PIs) in HIV patients on rifampicin-based tuberculosis (TB) treatment and how this affected HIV treatment outcomes.

methodsWe reviewed clinical records of HIV patients aged 13 years and above, treated with rifampicin-based TB treatment while on PIs between1st-January -2013 and 30th-September-2018 from twelve public HIV clinics in Uganda. Appropriate PI prescription during rifampicin-based TB treatment was defined as; prescribing doubled dose lopinavir/ritonavir- (LPV/r 800/200 mg twice daily) and inappropriate PI prescription as prescribing standard dose LPV/r or atazanavir/ritonavir (ATV/r).

resultsOf the 602 patients who were on both PIs and rifampicin, 103 patients (17.1% (95% CI: 14.3-20.34)) received an appropriate PI prescription. There were no significant differences in the two-year mortality (4.8 vs. 5.7%, P = 0.318), loss to follow up (23.8 vs. 18.9%, P = 0.318) and one-year post TB treatment virologic failure rates (31.6 vs. 30.7%, P = 0.471) between patients that had an appropriate PI prescription and those that did not. However, more patients on double dose LPV/r had missed anti-retroviral therapy (ART) days (35.9 vs 21%, P = 0.001).

conclusionWe conclude that despite availability of clinical evidence, double dosing LPV/r in patients receiving rifampicin-based TB treatment is low in Uganda's public HIV clinics but this does not seem to affect patient survival and viral suppression.

Indexed as

Guidelines as TopicAdolescentAdultAgedAnti-HIV AgentsCoinfectionDrug Therapy, CombinationFemaleHIV InfectionsHIV Protease InhibitorsHumansInappropriate PrescribingLopinavirMiddle AgedProtease InhibitorsRifampinAnti-HIV AgentsHIV Protease InhibitorsLopinavirProtease InhibitorsRifampinRitonavirDrug-drug interactionsProtease inhibitorsTuberculosis

Identifiers

PMID34399706
PMCPMC8369708
OpenAlexW3195180838

What OpenQuestion holds

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LicenceCC BY
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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.