ArticleAIDS research and therapy2022
Advanced HIV disease management practices within inpatient medicine units at a referral hospital in Zambia: a retrospective chart review.
Article in AIDS research and therapy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07720128 (Advanced HIV Re-engagement in Care), which is not on this map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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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.
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.
Advanced HIV Re-engagement in Care
Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.
- Pooled it
- Trial
- Sociodemographic and Clinical Determinants of Adults With Advanced HIV Disease on Antiretroviral Therapy in West Oromia, Ethiopia: A Hospital-Based Retrospective Study.AIDS research and treatment · 2026Article
- Closing the "Missing Middle" in Advanced HIV Disease Care for Adolescents in Sub-Saharan Africa: Early Identification, Integrated Care, and Continuity After Discharge.HIV/AIDS (Auckland, N.Z.) · 2026Article
- Uptake and disparities in tuberculosis screening using urine-lipoarabinomannan among patients with advanced human immunodeficiency virus-disease in Africa: A systematic review.World journal of virology · 2025Article
- Advanced HIV disease management and patient outcomes in rural setting - Malawi: a retrospective cohort study.AIDS research and therapy · 2025Article
- A cross-sectional study evaluating the screening, diagnosis and management of advanced HIV disease at the AIDS support organization service centre in Mbarara City, Southwestern Uganda.BMC infectious diseases · 2025Article
- Assessment of antimicrobial resistance laboratory-based surveillance capacity of hospitals in Zambia: findings and implications for system strengthening.The Journal of hospital infection · 2024Article
- Community antibiotic consumption and associated factors in Lusaka district of Zambia: findings and implications for antimicrobial resistance and stewardship.JAC-antimicrobial resistance · 2024Article
- Antifungal resistance and stewardship: a knowledge, attitudes and practices survey among pharmacy students at the University of Zambia; findings and implications.JAC-antimicrobial resistance · 2023Article
- Barriers and facilitators to implementing Advanced HIV Disease screening at secondary referral hospital -Malawi: Asequential exploratory mixed method-study.Research square · 2023Article
Corrections and comments
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Authors and funding
12 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundZambia recently achieved UNAIDS 90-90-90 treatment targets for HIV epidemic control; however, inpatient facilities continue to face a large burden of patients with advanced HIV disease and HIV-related mortality. Management of advanced HIV disease, following guidelines from outpatient settings, may be more difficult within complex inpatient settings. We evaluated adherence to HIV guidelines during hospitalization, including opportunistic infection (OI) screening, treatment, and prophylaxis.
methodsWe reviewed inpatient medical records of people living with HIV (PLHIV) admitted to the University Teaching Hospital in Lusaka, Zambia between December 1, 2018 and April 30, 2019. We collected data on patient demographics, antiretroviral therapy (ART), HIV biomarkers, and OI screening and treatment-including tuberculosis (TB), Cryptococcus, and OI prophylaxis with co-trimoxazole (CTX). Screening and treatment cascades were constructed based on the 2017 WHO Advanced HIV Guidelines.
resultsWe reviewed files from 200 charts of patients with advanced HIV disease; of these 92% (184/200) had been on ART previously; 58.1% (107/184) for more than 12 months. HIV viral load (VL) testing was uncommon but half of VL results were high. 39% (77/200) of patients had a documented CD4 count result. Of the 172 patients not on anti-TB treatment (ATT) on admission, TB diagnostic tests (either sputum Xpert MTB/RIF MTB/RIF or urine TB-LAM) were requested for 105 (61%) and resulted for 60 of the 105 (57%). Nine of the 14 patients (64%) with a positive lab result for TB died before results were available. Testing for Cryptococcosis was performed predominantly in patients with symptoms of meningitis. Urine TB-LAM testing was rarely performed.
conclusionsAt a referral hospital in Zambia, CD4 testing was inconsistent due to laboratory challenges and this reduced recognition of AHD and implementation of AHD guidelines. HIV programs can potentially reduce mortality and identify PLHIV with retention and adherence issues through strengthening inpatient activities, including reflex VL testing, TB-LAM and serum CrAg during hospitalization.
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