Observational studyClinical infectious diseases : an official publication of the Infectious Diseases Society of America2022
Adherence Measured Using Electronic Dose Monitoring is Associated with Emergent Antiretroviral Resistance and Poor Outcomes in People with Human Immunodeficiency Virus/AIDS and Multidrug-Resistant Tuberculosis.
Observational study in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03162107 (Promoting Engagement in the Drug Resistant TB/HIV Care Continuum in South Africa PRAXIS Study), which is not on this map. Cited by 14 papers.
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.
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.
Promoting Engagement in the Drug Resistant TB/HIV Care Continuum in South Africa PRAXIS Study (PRospective Study of Adherence in M/XDR-TB Implementation Science)
Who cites it
14 citing papers in PubMed, 20 citations in OpenAlex.
- A Retrospective Analysis Examining the Impact of Educational Attainment and Social Determinants of Health on Rifampicin-Resistant Tuberculosis Treatment Outcomes.Open forum infectious diseases · 2026Article
- Early adherence predicts treatment outcomes and mortality in people living with HIV and multidrug-resistant tuberculosis.Annals of epidemiology · 2026Article
- Prevalence and associated factors of rifampicin resistance pulmonary tuberculosis among HIV-positive patients in Bahir Dar, Northwest, Ethiopia.Scientific reports · 2026Article
- Socio-ecological vulnerability subgroups predict adherence and treatment outcomes in multidrug-resistant tuberculosis and HIV: a latent class analysis.BMC infectious diseases · 2026Article
- Body mass index (BMI) at RR-TB diagnosis as an independent predictor of treatment outcomes: a retrospective analysis.BMC infectious diseases · 2026Article
- Electronic Dose Monitoring Feedback (EMF) with Youth Living with HIV: Qualitative Exploration of Reactions to Viewing Dosing Calendars.AIDS and behavior · 2025Article
- Experiences of key populations in multidrug-resistant TB and HIV.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2025Article
- Tuberculosis treatment outcomes and their related factors in patients with tuberculosis treated at the Antituberculosis Center of Brazzaville, Republic of Congo.IJID regions · 2025Article
- Viral suppression in the context of SARS-CoV-2 among children infected with HIV-1 monitored in five health facilities in Benin.BMC infectious diseases · 2025Article
- Article
- Differentiated service delivery framework for people with multidrug-resistant tuberculosis and HIV co-infection.Journal of acquired immune deficiency syndromes (1999) · 2024Article
- Relationship between HIV viral suppression and multidrug resistant tuberculosis treatment outcomes.PLOS global public health · 2024Article
- Article
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors at 8 institutions in 2 countries.
Funding
Abstract
backgroundMedication adherence is known to challenge treatment of human immunodeficiency virus (HIV)/AIDS and multidrug-resistant tuberculosis (MDR-TB). We hypothesized that adherence using electronic dose monitoring (EDM) would identify an antiretroviral therapy (ART) adherence threshold for emergent ART resistance and predict treatment outcomes in patients with MDR-TB and HIV on ART and bedaquiline-containing TB regimens.
methodsA prospective cohort of adults with MDR-TB and HIV on ART and initiating MDR-TB treatment with bedaquiline were enrolled at a public hospital in KwaZulu-Natal, South Africa (PRAXIS Study). Participants received separate EDM devices that measure adherence to bedaquiline and ART (nevirapine or lopinavir/ritonavir). Adherence was calculated cumulatively over 6 months. Participants were followed through completion of MDR-TB treatment. HIV genome sequencing was performed at baseline and 2 and 6 months on samples with HIV RNA ≥1000 copies/mL.
resultsFrom November 2016 through February 2018, 198 persons with MDR-TB and HIV were enrolled and followed (median, 17.2 months; interquartile range, 12.2-19.6). Eleven percent had baseline ART resistance mutations, and 7.5% developed emergent ART resistance at 6 months. ART adherence was independently associated with ART resistance and mortality. Modeling identified a significant (P < .001), linear association between ART adherence and emergent resistance, suggesting a strong association without a specific threshold.
conclusionsOur findings highlight the need for ART resistance testing, especially in patients with MDR-TB and HIV, which is currently not the standard of care in resource-limited settings. Despite short follow-up duration, reduced ART adherence was significantly associated with emergent resistance and increased mortality. CLINICAL TRIALS REGISTRATION: NCT03162107.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.