Evidence map›Paper›PMID 36536672›Full record

ArticlePatient preference and adherence2022

Virological Outcomes After Switching to Abacavir/Lamivudine/Dolutegravir Combined with Adherence Support in People Living with HIV with Poor Adherence: A Phase IV, Multicentre Randomized Prospective Open Label Study (TriiADD-CTN 286).

Marina B Klein, Jim Young, David Ortiz-Paredes, Shouao Wang, Sharon Walmsley, Alexander Wong, Valérie Martel-Laferrière, Neora Pick, Brian Conway, Jonathan Angel and 10 more

Open access · goldAbstract read
In one paragraph

Article in Patient preference and adherence, 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
0.1field-weighted citation impact, top 54% 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

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

  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

20 authors at 11 institutions in 1 country.

Marina B KleinDivision of Infectious Diseases and Chronic Viral Illness Service, Department of Medicine, McGill University Health Centre, Montreal, Canada.ORCID 0000-0002-3063-8430
Jim YoungDepartment of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada.ORCID 0000-0002-4314-3007
David Ortiz-ParedesCentre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Canada.ORCID 0000-0002-0431-4889
Shouao WangCentre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Canada.
Sharon WalmsleyCanadian Institutes of Health Research, Canadian HIV Trials Network, Vancouver, Canada.
Alexander WongDepartment of Medicine, University of Saskatchewan, Regina, Canada.
Valérie Martel-LaferrièreDepartment of Microbiology and Infectious Diseases, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montreal, Canada.
Neora PickDepartment of Medicine, Division of Infectious Diseases, University of British Columbia, Vancouver, Canada.ORCID 0000-0003-4123-3698
Brian ConwayVancouver Infectious Diseases Centre, Vancouver, Canada.
Jonathan AngelOttawa Hospital Research Institute, Ottawa, Canada.
Jean-Guy BarilClinique de Médecine Urbaine du Quartier Latin, Montreal, Canada.
Chris FraserCool Aid Community Health Centre, Victoria, Canada.
Bertrand LebouchéCentre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Canada.
Darrell H S TanToronto General Hospital Research Institute, University Health Network, Toronto, Canada.ORCID 0000-0002-3069-2875
Roger SandreHAVEN Program, Health Sciences North, Sudbury, Canada.
Sylvie TrottierCentre de Recherche du CHU de Québec, Department of Microbiology, Infectiology and Immunology, Université Laval, Quebec, Canada.
Hansi PeirisCentre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Canada.
Jayamarx JayaramanCanadian Institutes of Health Research, Canadian HIV Trials Network, Vancouver, Canada.
Joel SingerCanadian Institutes of Health Research, Canadian HIV Trials Network, Vancouver, Canada.
CTN 286 Study Investigators
McGill University Health Centre · CACanadian Institutes of Health Research · CAUniversity Health Network · CACentre Hospitalier de l’Université de Montréal · CACentre hospitalier de l'Université Laval · CAHealth Sciences North · CAMcGill University · CAOttawa Hospital · CAUniversity of British Columbia · CAUniversity of Regina · CAVancouver Infectious Diseases Centre · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Many people living with HIV struggle to consistently adhere to antiretroviral therapy, fail to achieve long-term virologic control and remain at risk for HIV-related disease progression, development of resistance and may transmit HIV infection to others. Objective: To determine if switching from current multi-tablet (curART) to single-tablet antiretroviral therapy (abacavir/lamivudine/dolutegravir; ABC/3TC/DTG), both combined with individualized adherence support, would improve HIV suppression in non-adherent vulnerable populations. Methods: TriiADD was an investigator-initiated randomized, multicentre, open label study. HIV+ adults with documented non-adherence on curART were randomized in a 1:1 ratio to immediately switch to ABC/3TC/DTG or to continue curART. Both arms received adherence support. The primary outcome was the proportion of participants in each arm with HIV RNA < 50 copies/mL 24 weeks after randomization. Results: In total, 50 people were screened and 27 randomized from 11 sites across Canada before the trial was stopped early due to slow recruitment. Participants were predominantly from ethnocultural communities, Indigenous people and/or had a history of injection drug use. The proportion achieving HIV RNA < 50 copies/mL at week 24 was 4/12 (33%) in the curART arm vs 7/13 (54%) in the ABC/3TC/DTG arm; median Bayesian risk difference, 5% (95% CrI, -17 to 28%) higher for those randomized to ABC/3TC/DTG. We encountered difficulties with recruitment of participants without prior drug resistance, retention despite intensive support, reliably measuring adherence and in overcoming entrenched adherence barriers. Conclusion: Results of our trial are consistent with a slight improvement in viral suppression in a vulnerable population when a single tablet regimen is combined with patient-level adherence support. Beyond treatment simplicity and tolerability, tailored interventions addressing stigma and social determinants of health are still needed. The numerous challenges we encountered illustrate how randomised trials may not be the best approach for assessing adherence interventions in vulnerable populations.

Indexed as

adherence interventionsantiretroviral therapyHIVhuman immunodeficiency virussingle tablet regimenvulnerable populations

Identifiers

PMID36536672
PMCPMC9759014
OpenAlexW4311354885

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.