Evidence map›Paper›PMID 36357837›Full record

ArticleBMC infectious diseases2022

Determinants of therapy failure among adults on first-line antiretroviral therapy in Asmara, Eritrea: a multicenter retrospective matched case-control study.

Samuel Tekle Mengistu, Ghirmay Ghebrekidan Ghebremeskel, Hermon Berhe Ghebrat, Oliver Okoth Achila, Nahom Asmerom Yohannes, Amon Solomon Ghebrenegus, Filmon Ghebretsadik Wendmhuney, Naod Yeibyo, Amanuel Kidane Andegiorgish, Araia Berhane Mesfin and 1 more

Abstract readMulticenter Study
In one paragraph

Article in BMC infectious diseases, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. 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.

Samuel Tekle MengistuNakfa Hospital, Ministry of Health Northern Red Sea Branch, Nakfa, Eritrea. teklesam7@gmail.com.ORCID http://orcid.org/0000-0002-2817-1421
Ghirmay Ghebrekidan GhebremeskelNakfa Hospital, Ministry of Health Northern Red Sea Branch, Nakfa, Eritrea.ORCID http://orcid.org/0000-0002-0275-2279
Hermon Berhe GhebratAf'abet Hospital, Ministry of Health Northern Red Sea Branch, Nakfa, Eritrea.ORCID http://orcid.org/0000-0001-5495-3366
Oliver Okoth AchilaUnit of Clinical Laboratory Science, Orotta College of Medicine and Health Sciences, Asmara, Eritrea.ORCID http://orcid.org/0000-0001-8013-0785
Nahom Asmerom YohannesGedem Naval Hospital, Gedem, Eritrea.ORCID http://orcid.org/0000-0001-8993-3015
Amon Solomon GhebrenegusHazhaz Zonal Referral Hospital, Asmara, Eritrea.
Filmon Ghebretsadik WendmhuneyHalibet National Referral Hospital, Asmara, Eritrea.
Naod YeibyoGhindae Zonal Referral Hospital, Ministry of Health Northern Red Sea Branch, Ghindae, Eritrea.
Amanuel Kidane AndegiorgishDepartment of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, People's Republic of China.ORCID http://orcid.org/0000-0002-3045-3153
Araia Berhane MesfinCommunicable Disease Control Division, Ministry of Health, Asmara, Eritrea.ORCID http://orcid.org/0000-0003-0815-2917
Negassi LeakeDepartment of Internal Medicine, Orotta College of Medicine and Health Sciences, Asmara, Eritrea.ORCID http://orcid.org/0000-0003-0164-8530

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundInformation on treatment failure (TF) in People living with HIV in a data-poor setting is necessary to counter the epidemic of TF with first-line combined antiretroviral therapies (cART) in sub-Saharan Africa (SSA). In this study, we examined the risk factors associated with TF in Asmara, Eritrea from 2001 to 2020.

methodsA multicenter, retrospective 1:2 matched (by age and gender) case-control study was conducted in four major hospitals in Asmara, Eritrea on adults aged ≥ 18 years who were on treatment for at least 6 months. Cases were patients who fulfills at least one of the WHO therapy failure criterion during the study period. Controls were randomly selected patients on first-line treatment and plasma viral load < 1000 copies/ml in their latest follow-up measurement. Multivariable logistic regression analysis was conducted to identify risk factors for TF. All P-values were 2-sided and the level of significance was set at P < 0.05 for all analyses.

resultsOf the 1068 participants (356 cases; 712 controls), 585 (54.7%) were females. The median age at treatment initiation was 46 years [interquartile range (IQR): 39-51]. Median time to combined antiretroviral therapy (cART) failure was 37 months (IQR = 24-47). In the multivariate analysis, factors associated with increased likelihood of TF included initial nucleoside reverse transcriptase inhibitors (NRTI) backbone (Zidovudine + Lamivudine (AZT + 3TC): adjusted odds ratio (aOR) = 2.70, 95% Confidence interval (CI): 1.65-4.41, P-value < 0.001), (Abacavir + lamivudine (ABC + 3TC): aOR = 4.73, 95%CI: 1.18-18.92, P-value = 0.028], and (Stavudine + Lamivudine (D4T + 3TC): aOR = 5.00; 95% CI: 3.03-8.20, P-value < 0.001) in comparison to Emtricitabine and Tenofovir diproxil fumarate (FTC + TDF). Additional associations included prior exposure to cART (aOR = 2.28, 95%CI: 1.35-3.86; P- value = 0.002), record of sub-optimal drug adherence (aOR = 3.08, 95%CI: 2.22-4.28; P < 0.001), ambulatory/bedridden at presentation (aOR = 1.61, 95%CI: 1.12-4.28; P-value = 0.010), presence of comorbidities (aOR = 2.37; 95%CI: 1.36-4.10, P-value = 0.002), duration of cART (< 5 years: aOR: 5.90; 95% CI: 3.95-8.73, P-value < 0.001), and use of SMX-TMP prophylaxis (aOR = 2.00, 95%CI, 1.44-2.78, P-value < 0.001).

conclusionOur findings underscore the importance of optimizing cART adherence, diversification of cART regimens, and interventions directed at enhancing early HIV diagnosis, prompt initiations of treatment, and improved patient-focused monitoring of treatment response.

Indexed as

Anti-HIV AgentsHIV InfectionsAdultAnti-Retroviral AgentsCase-Control StudiesEmtricitabineEritreaFemaleHumansLamivudineMaleMiddle AgedRetrospective StudiesStavudineViral LoadAnti-HIV AgentsAnti-Retroviral AgentsEmtricitabineLamivudineStavudineCD4+ cell countEritreaHIVTreatment failureViral load

Identifiers

PMID36357837
PMCPMC9650854

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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.