Evidence map›Paper›PMID 35690762›Full record

ArticleBMC pediatrics2022

Risk factors for sustained virological non-suppression among children and adolescents living with HIV in Zimbabwe and Malawi: a secondary data analysis.

Christi Jackson, Andrea M Rehman, Grace McHugh, Carmen Gonzalez-Martinez, Lucky G Ngwira, Tsitsi Bandason, Hilda Mujuru, Jon O Odland, Elizabeth L Corbett, Rashida A Ferrand and 1 more

Registry-linked trialOpen access · goldAbstract read
In one paragraph

Article in BMC pediatrics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02426112 (Bronchopulmonary Function in Response to Azithromycin Treatment for Chronic Lung Disease in HIV-infected Children), which is not on this map. Cited by 6 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 2 pooled it
0.7field-weighted citation impact, top 30% 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.

NCT02426112 phase3completednot on this map

Bronchopulmonary Function in Response to Azithromycin Treatment for Chronic Lung Disease in HIV-infected Children

TypeinterventionalSponsorLondon School of Hygiene and Tropical MedicineRan2016 to 2019Enrolled347ConditionsChronic Lung Disease, HIV InfectionArmsAzithromycin, Placebo
3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 2 syntheses or guidelines pooled it, 7 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Article
  6. 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

11 authors at 6 institutions in 5 countries.

Christi JacksonDepartment of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK. christi.jxn@gmail.com.
Andrea M RehmanMRC International Statistics and Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.
Grace McHughBiomedical Research and Training Institute, Harare, Zimbabwe.
Carmen Gonzalez-MartinezMalawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi.
Lucky G NgwiraMalawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi.
Tsitsi BandasonBiomedical Research and Training Institute, Harare, Zimbabwe.
Hilda MujuruDepartment of Paediatrics, University of Zimbabwe, Harare, Zimbabwe.
Jon O OdlandSchool of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
Elizabeth L CorbettDepartment of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK.
Rashida A FerrandDepartment of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK.
Victoria SimmsMRC International Statistics and Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.
Biomedical Research and Training Institute · ZWLondon School of Hygiene & Tropical Medicine · GBMalawi-Liverpool-Wellcome Trust Clinical Research Programme · MWUniversity of Liverpool · GBUniversity of Pretoria · ZAUniversity of Zimbabwe · ZW

Funding

Medical Research Council MR/R010161/1Wellcome Trust 206316/Z/17/Z
6 · The paper itself

Abstract

backgroundWe investigated risk factors for sustained virological non-suppression (viral load ≥ 1000 copies/ml on two tests 48 weeks apart) among children and adolescents accessing HIV care in public sector clinics in Harare, Zimbabwe and Blantyre, Malawi.

methodsParticipants were enrolled between 2016 and 2019, were aged 6-19 years, living with HIV, had chronic lung disease (FEV z-score < -1) and had taken antiretroviral therapy (ART) for at least six months. We used multivariate logistic regression to identify risk factors for virological non-suppression after 48 weeks, among participants who were non-suppressed at enrolment.

resultsAt enrolment 258 participants (64.6%) were on first-line ART and 152/347 (43.8%) had virological non-suppression. After 48 weeks 114/313 (36.4%) were non-suppressed. Participants non-suppressed at baseline had almost ten times higher odds of non-suppression at follow-up (OR = 9.9, 95%CI 5.3-18.4, p < 0.001). Of those who were non-suppressed at enrolment, 87/136 (64.0%) were still non-suppressed at 48 weeks. Among this group non-suppression at 48 weeks was associated with not switching ART regimen (adjusted OR = 5.55; 95%CI 1.41-21.83); p = 0.014) and with older age. Twelve participants switched regimen in Zimbabwe and none in Malawi.

conclusionsViral non-suppression was high among this group and many with high viral load were not switched to a new regimen, resulting in continued non-suppression after 48 weeks. Further research could determine whether improved adherence counselling and training clinicians on regimen switches can improve viral suppression rates in this population.

trial registrationSecondary cohort analysis of data from BREATHE trial (Clinicaltrials.gov NCT02426112 ).

Indexed as

Anti-HIV AgentsHIV InfectionsAdolescentChildData AnalysisHumansMalawiRisk FactorsViral LoadZimbabweAnti-HIV AgentsAdolescentAntiretroviral therapyChronic lung diseaseHIV viral loadResistanceViral non-suppression

Identifiers

PMID35690762
PMCPMC9188224
OpenAlexW4282914777

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.