Evidence map›Paper›PMID 36103496›Full record

ArticlePloS one2022

The differential impacts of early detection and accelerated antiretroviral therapy on the epidemiologic trend of sexually acquired HIV infection in Hong Kong.

Paul Kwok-Ming Poon, Ngai-Sze Wong, Wai-Shing Leung, Bonnie Chun-Kwan Wong, Tsz-Shan Kwong, Tsz-Ho Kwan, Grace Chung-Yan Lui, Owen Tak-Yin Tsang, Man-Po Lee, Ka-Hing Wong and 1 more

Open access · goldAbstract read
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. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.2field-weighted citation impact, top 49% 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, 3 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Review
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 3 institutions in 2 countries.

Paul Kwok-Ming PoonThe Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.ORCID 0000-0003-4252-0656
Ngai-Sze WongThe Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
Wai-Shing LeungDepartment of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong, China.ORCID 0000-0001-8377-085X
Bonnie Chun-Kwan WongDepartment of Health, Special Preventive Programme, Hong Kong Special Administrative Region Government, Hong Kong, China.
Tsz-Shan KwongDepartment of Medicine, Queen Elizabeth Hospital, Hong Kong, China.
Tsz-Ho KwanThe Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.ORCID 0000-0002-2855-5038
Grace Chung-Yan LuiStanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong, China.ORCID 0000-0001-5242-2967
Owen Tak-Yin TsangDepartment of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong, China.
Man-Po LeeDepartment of Medicine, Queen Elizabeth Hospital, Hong Kong, China.
Ka-Hing WongDepartment of Health, Special Preventive Programme, Hong Kong Special Administrative Region Government, Hong Kong, China.
Shui-Shan LeeThe Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.ORCID 0000-0003-1448-765X
Chinese University of Hong Kong · HKDepartment of Health · CNQueen Elizabeth Hospital · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo assess impacts of early detection and prompt antiretroviral therapy (ART) on the latest epidemiologic situation to inform intervention strategy.

methodsWe analysed data from two clinical cohorts in Hong Kong where sexual transmission accounted for the majority of HIV infections. The two cohorts comprised patients newly diagnosed in 2007-2008 and 2016-2018 respectively. Secular trend and differences between men who have sex with men (MSM) and heterosexual patients were examined. Predictors of late presentation (defined as CD4 ≤350 or AIDS-defining illness within 3 months of diagnosis) and prolonged interval between diagnosis and ART initiation were assessed by multivariable regressions.

resultsThere were 1,136 newly diagnosed HIV patients with 644 in the first and 492 in the second cohort, a majority (91.7%) presented with sexually acquired infection. There were less MSM in the first than the second cohort (50.3%% vs 87.8%, χ2 = 117.05, p<0.001). The mean (SD) number of days between diagnosis and ART initiation decreased from 514.3 (516.1) to 61.8 (94.2) days across the two cohorts. Younger age, non-Chinese, outpatient-based service and lower CD4 count were predictors of faster ART initiation in the first but not in the second cohort. Interval between diagnosis and ART initiation became highly uniform among groups in the second cohort. Nearly 60% were classified as late presenters in both cohorts. Heterosexuals (aOR 1.58, 95% CI 1.13-2.19) had a higher risk of late presentation.

conclusionsThere was remarkable improvement in acceleration of ART initiation. Clinical implementation of accelerated ART recommendations has been effective for both MSM and heterosexuals. Late presentation was more marked among heterosexuals and remained a problem. The continued phenomenon of late presentation could offset the epidemiologic gains from accelerated ART initiation.

Indexed as

HIV InfectionsSexual and Gender MinoritiesCD4 Lymphocyte CountHomosexuality, MaleHong KongHumansMale

Identifiers

PMID36103496
PMCPMC9473389
OpenAlexW4295709284

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.