Evidence map›Paper›PMID 36880429›Full record

ArticleJournal of the International AIDS Society2023

Modelling the impact of CD4 testing on mortality from TB and cryptococcal meningitis among patients with advanced HIV disease in nine countries.

Ikwo Kitefre Oboho, Heather Paulin, Carl Corcoran, Matt Hamilton, Alex Jordan, Hannah L Kirking, Elfriede Agyemang, Laura Jean Podewils, Carel Pretorius, Greg Greene and 5 more

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

Article in Journal of the International AIDS Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.1field-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

5 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. Review
  3. Article
  4. CD4Open life sciences · 2023
    Article
  5. Disseminated Herpes Zoster with Decreased CD4 Counts in a HIV-Infected Patient.Clinical, cosmetic and investigational dermatology · 2023
    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

15 authors at 2 institutions in 3 countries.

Ikwo Kitefre ObohoDivision of Global HIV and TB, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.ORCID 0000-0002-0654-0900
Heather PaulinDivision of Global HIV and TB, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Carl CorcoranDivision of Global HIV and TB, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Matt HamiltonAvenir Health, Glastonbury, Connecticut, USA.
Alex JordanDivision of Foodborne, Waterborne and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Hannah L KirkingDivision of Global HIV and TB, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Elfriede AgyemangDivision of Global HIV and TB, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Laura Jean PodewilsDivision of Global HIV and TB, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Carel PretoriusAvenir Health, Glastonbury, Connecticut, USA.
Greg GreeneDivision of Foodborne, Waterborne and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Tom ChillerDivision of Foodborne, Waterborne and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Mitesh DesaiDivision of Global HIV and TB, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Roma BhatkotiDivision of Global HIV and TB, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Ray W ShiraishiDivision of Global HIV and TB, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
N Sarita ShahDivision of Global HIV and TB, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Centers for Disease Control and Prevention · USAvenir Health · US

Funding

Emory/Georgia TB Research Advancement Center (TRAC)P30AI168386 · NIAID · EMORY UNIVERSITY · PI Jeffrey M Collins · 2022 to 2026
$5.8M
CGH CDC HHS U2G GH000994NIAID NIH HHS P30 AI168386PEPFAR
6 · The paper itself

Abstract

introductionDespite antiretroviral therapy (ART) scale-up among people living with HIV (PLHIV), those with advanced HIV disease (AHD) (defined in adults as CD4 count <200 cells/mm

methodsWe used official estimates and existing epidemiological data to project deaths from tuberculosis (TB) and cryptococcal meningitis (CM) among PLHIV-initiating ART with CD4 <200 cells/mm

resultsThe effect of CD4 testing comes through increased identification of AHD and consequent eligibility for protocols for AHD prevention, diagnosis and management; algorithms for CD4 testing avert between 31% and 38% of deaths from TB and CM in the first year of ART. The number of CD4 tests required per death averted varies widely by country from approximately 101 for South Africa to 917 for Kenya.

conclusionsThis analysis supports retaining baseline CD4 testing to avert deaths from TB and CM, the two most deadly opportunistic infections among patients with AHD. However, national programmes will need to weigh the cost of increasing CD4 access against other HIV-related priorities and allocate resources accordingly.

Indexed as

HIV InfectionsMeningitis, CryptococcalOpportunistic InfectionsTuberculosisAdultAlgorithmsCD4 AntigensHumansCD4 Antigensadvanced HIV diseaseCD4 testingcryptococcal meningitisdeaths avertedmortalityTB mortality

Identifiers

PMID36880429
PMCPMC9989935
OpenAlexW4323347723

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.