Evidence map›Paper›PMID 35775502›Full record

Trial reportJournal of the International AIDS Society2022

HIV drug resistance in a community-randomized trial of universal testing and treatment: HPTN 071 (PopART).

Jessica M Fogel, Ethan A Wilson, Estelle Piwowar-Manning, Autumn Breaud, William Clarke, Christos Petropoulos, Ayana Moore, Christophe Fraser, Barry Kosloff, Kwame Shanaube and 10 more

Open access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of the International AIDS Society, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.0field-weighted citation impact, top 23% 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

6 citing papers in PubMed, 11 citations in OpenAlex.

  1. Trial
  2. Trial
  3. Article
  4. Article
  5. Observational
  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

20 authors at 10 institutions in 4 countries.

Jessica M FogelDepartment of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.ORCID 0000-0003-3143-9000
Ethan A WilsonFred Hutchinson Cancer Research Center, Seattle, Washington, USA.
Estelle Piwowar-ManningDepartment of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Autumn BreaudDepartment of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
William ClarkeDepartment of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Christos PetropoulosMonogram Biosciences, San Francisco, California, USA.
Ayana MooreFHI 360, Durham, North Carolina, USA.
Christophe FraserThe Big Data Institute and Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
Barry KosloffZambart, Lusaka, Zambia.
Kwame ShanaubeZambart, Lusaka, Zambia.ORCID 0000-0001-7899-0890
Gert van ZylDivision of Medical Virology, Stellenbosch University, Cape Town, South Africa.ORCID 0000-0003-3021-5101
Michelle ScheepersDesmond Tutu TB Center, Department of Paediatrics and Child Health, Stellenbosch University, Western Cape, South Africa.
Sian FloydDepartment of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
Peter BockDesmond Tutu TB Center, Department of Paediatrics and Child Health, Stellenbosch University, Western Cape, South Africa.ORCID 0000-0003-3211-6078
Helen AylesZambart, Lusaka, Zambia.ORCID 0000-0003-4108-2842
Sarah FidlerDepartment of Infectious Disease, HIV Clinical Trials Unit, Imperial College London, London, UK.ORCID 0000-0003-1676-7583
Richard HayesDepartment of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.ORCID 0000-0002-1729-9892
Deborah DonnellFred Hutchinson Cancer Research Center, Seattle, Washington, USA.ORCID 0000-0002-0587-7480
Susan H EshlemanDepartment of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.ORCID 0000-0002-4587-791X
HPTN 071 (PopART) Study Team
Johns Hopkins University · USLondon School of Hygiene & Tropical Medicine · GBFred Hutch Cancer Center · USWestern Cape Department of Health · ZACentre for Human Genetics · GBFamily Health International 360 · USIGM Biosciences (United States) · USMRC Clinical Trials Unit at UCL · GBStellenbosch University · ZAZambart · ZM

Funding

SDMC: HPTN 084 Pregnancy SupplementUM1AI068617 · NIAID · FRED HUTCHINSON CANCER RESEARCH CENTER · PI Elizabeth Renata Brown, Deborah J Donnell · 2011 to 2026
$204.9M
Stellenbosch University Clinical Trial Unit, Cape Town, South AfricaUM1AI069521 · NIAID · STELLENBOSCH UNIVERSITY · PI Shaun Barnabas, Anneke Catharina Hesseling · 2012 to 2026
$21.5M
Medical Research Council MR/R010161/1NIAID NIH HHS UM1 AI068617NIAID NIH HHS UM1 AI069521
6 · The paper itself

Abstract

introductionUniversal HIV testing and treatment (UTT) has individual and public health benefits. HPTN 071 (PopART), a community-randomized trial in Zambia and South Africa, demonstrated that UTT decreased HIV incidence. This endpoint was assessed in a cohort of >48,000 randomly selected adults in the study communities. We evaluated the impact of UTT on HIV drug resistance in this cohort and compared other resistance-related outcomes in participants with recent versus non-recent HIV infection.

methodsTwo years after the start of HPTN 071 (2016-2017), 6259 participants were HIV positive and 1902 were viremic (viral load >400 copies/ml). HIV genotyping and antiretroviral (ARV) drug testing were performed for viremic participants in three groups: seroconverters (infected <1 year), non-seroconverters (infected >1 year, random subset) and participants with unknown duration of infection (random subset). A two-stage cluster-based approach was used to assess the impact of the study intervention on drug resistance. Treatment failure was defined as being viremic with ARV drugs detected. Participants were classified as ARV naïve based on self-report and ARV drug testing.

resultsGenotyping results were obtained for 758 participants (143 seroconverters; 534 non-seroconverters; and 81 unknown duration of infection). The estimated prevalence of resistance in the study communities was 37% for all viremic persons and 11% for all HIV-positive persons. There was no association between UTT and drug resistance. Resistance was detected in 14.0% of seroconverters and 40.8% of non-seroconverters (non-nucleoside reverse transcriptase inhibitor resistance: 14.0% and 39.9%; nucleoside/nucleotide reverse transcriptase inhibitor resistance: 0.7% and 15.5%; protease inhibitor resistance: 0% and 1.9%; multi-class resistance: 0.7% and 16.1%, respectively). ARV drugs were detected in 2/139 (1.4%) of seroconverters and 94/534 (17.6%) of non-seroconverters tested. These participants were classified as failing ART; 88 (93.6%) of the non-seroconverters failing ART had resistance. Mutations used for surveillance of transmitted drug resistance were detected in 10.5% of seroconverters and 15.1% of non-seroconverters who were ARV naive.

conclusionsUTT was not associated with an increase in drug resistance in this cohort. Higher rates of drug resistance and multi-class resistance were observed in non-seroconverters compared to seroconverters.

Indexed as

HIV InfectionsAdultAnti-Retroviral AgentsDrug ResistanceHumansReverse Transcriptase InhibitorsViral LoadViremiaAnti-Retroviral AgentsReverse Transcriptase InhibitorsAfricaARVclinical trialsdrug resistanceHIV preventiontransmitted drug resistance

Identifiers

PMID35775502
PMCPMC9248006
OpenAlexW4283753870

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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.