Evidence map›Paper›PMID 35905123›Full record

ArticlePloS one2022

Viraemic-time predicts mortality among people living with HIV on second-line antiretroviral treatment in Myanmar: A retrospective cohort study.

Anita Mesic, Tom Decroo, Htay Thet Mar, Bart K M Jacobs, Moe Pyae Thandar, Thin Thin Thwe, Aung Aung Kyaw, Mitchell Sangma, David Beversluis, Elkin Bermudez-Aza and 7 more

Erratum issuedOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
0.5field-weighted citation impact, top 36% 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

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 5 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

17 authors at 6 institutions in 4 countries.

Anita MesicPublic Health Department, Médecins Sans Frontières, Amsterdam, The Netherlands.ORCID 0000-0002-7541-6380
Tom DecrooDepartment of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.ORCID 0000-0002-1205-1484
Htay Thet MarMedical Department, Médecins Sans Frontières, Yangon, Myanmar.
Bart K M JacobsDepartment of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.
Moe Pyae ThandarMedical Department, Médecins Sans Frontières, Yangon, Myanmar.
Thin Thin ThweMedical Department, Médecins Sans Frontières, Yangon, Myanmar.
Aung Aung KyawMedical Department, Médecins Sans Frontières, Yangon, Myanmar.
Mitchell SangmaMedical Department, Médecins Sans Frontières, Yangon, Myanmar.
David BeversluisPublic Health Department, Médecins Sans Frontières, Amsterdam, The Netherlands.
Elkin Bermudez-AzaPublic Health Department, Médecins Sans Frontières, Amsterdam, The Netherlands.
Alexander SpinaPublic Health Department, Médecins Sans Frontières, Amsterdam, The Netherlands.
Darli Po Po AungFondation Mérieux, Yangon, Myanmar.
Erwan PiriouPublic Health Department, Médecins Sans Frontières, Amsterdam, The Netherlands.
Koert RitmeijerPublic Health Department, Médecins Sans Frontières, Amsterdam, The Netherlands.
Josefien Van OlmenDepartment of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.
Htun Nyunt OoNational AIDS Programme, Ministry of Health and Sport, Naypyidaw, Myanmar.
Lutgarde LynenDepartment of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.
Médecins Sans Frontières · NLInstituut voor Tropische Geneeskunde · BEMinistry of Health and Sports · MMResearch Foundation - Flanders · BEUniversity of Antwerp · BEUniversity of Exeter · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionDespite HIV viral load (VL) monitoring being serial, most studies use a cross-sectional design to evaluate the virological status of a cohort. The objective of our study was to use a simplified approach to calculate viraemic-time: the proportion of follow-up time with unsuppressed VL above the limit of detection. We estimated risk factors for higher viraemic-time and whether viraemic-time predicted mortality in a second-line antiretroviral treatment (ART) cohort in Myanmar.

methodsWe conducted a retrospective cohort analysis of people living with HIV (PLHIV) who received second-line ART for a period >6 months and who had at least two HIV VL test results between 01 January 2014 and 30 April 2018. Fractional logistic regression assessed risk factors for having higher viraemic-time and Cox proportional hazards regression assessed the association between viraemic-time and mortality. Kaplan-Meier curves were plotted to illustrate survival probability for different viraemic-time categories.

resultsAmong 1,352 participants, 815 (60.3%) never experienced viraemia, and 172 (12.7%), 214 (15.8%), and 80 (5.9%) participants were viraemic <20%, 20-49%, and 50-79% of their total follow-up time, respectively. Few (71; 5.3%) participants were ≥80% of their total follow-up time viraemic. The odds for having higher viraemic-time were higher among people with a history of injecting drug use (aOR 2.01, 95% CI 1.30-3.10, p = 0.002), sex workers (aOR 2.10, 95% CI 1.11-4.00, p = 0.02) and patients treated with lopinavir/ritonavir (vs. atazanavir; aOR 1.53, 95% CI 1.12-2.10, p = 0.008). Viraemic-time was strongly associated with mortality hazard among those with 50-79% and ≥80% viraemic-time (aHR 2.92, 95% CI 1.21-7.10, p = 0.02 and aHR 2.71, 95% CI 1.22-6.01, p = 0.01). This association was not observed in those with viraemic-time <50%.

conclusionsKey populations were at risk for having a higher viraemic-time on second-line ART. Viraemic-time predicts clinical outcomes. Differentiated services should target subgroups at risk for a higher viraemic-time to control both HIV transmission and mortality.

Indexed as

Anti-HIV AgentsHIV InfectionsAnti-Retroviral AgentsCohort StudiesCross-Sectional StudiesHumansMyanmarRetrospective StudiesViral LoadViremiaAnti-HIV AgentsAnti-Retroviral Agents

Identifiers

PMID35905123
PMCPMC9337705
OpenAlexW4288700200

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.