Evidence map›Paper›PMID 39189824›Full record

Observational studyJournal of the International AIDS Society2024

Persistent low-level viraemia is associated with non-infectious comorbidities in an observational cohort in four African countries.

Allahna L Esber, Suze Colt, Ningbo Jian, Nicole Dear, Bonnie Slike, Valentine Sing'oei, Jonah Maswai, Michael Iroezindu, Emmanuel Bahemana, Hannah Kibuuka and 6 more

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Journal of the International AIDS Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–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

6 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
  4. Article
  5. Managing multimorbidity together: relationship dynamics and dual medication adherence for hypertension and HIV in Malawi.Annals of behavioral medicine : a publication of the Society of Behavioral Medicine · 2025
    Observational
  6. 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

16 authors.

Allahna L EsberU.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.ORCID https://orcid.org/0000-0001-5337-0126
Suze ColtU.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.
Ningbo JianU.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.
Nicole DearU.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.ORCID https://orcid.org/0000-0002-8026-9901
Bonnie SlikeU.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.
Valentine Sing'oeiU.S. Army Medical Research Directorate - Africa, Kisumu, Kenya.
Jonah MaswaiU.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.
Michael IroezinduU.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.
Emmanuel BahemanaU.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.
Hannah KibuukaMakerere University Walter Reed Project, Kampala, Uganda.
Christina S PolyakU.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.
Hendrik StreeckInstitute of Virology, University Hospital, Bonn, Germany.
Neha ShahU.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.
Trevor A CrowellU.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.ORCID https://orcid.org/0000-0001-5947-265X
Julie A AkeU.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.
AFRICOS Study Group

Funding

U.S. Department of Defense W81XWH-11-2-0174U.S. Department of Defense W81XWH-18-2-0040
6 · The paper itself

Abstract

introductionPeople living with HIV (PLWH) have higher rates of non-infectious comorbid diseases (NCDs) than individuals without HIV. We characterized the risk of NCDs among PLWH with undetectable viral load and persistent low-level viraemia (pLLV) in the African Cohort Study (AFRICOS). We secondarily quantified the role of immune activation in the association between LLV and NCDs.

methodsAFRICOS enrols participants in 12 clinics in Uganda, Kenya, Tanzania and Nigeria. Participants on antiretroviral therapy ≥ 6 months without an NCD at enrolment were included. PLLV was defined as at least two consecutive visits with a detectable viral load <1000 copies/ml. We examined elevated blood pressure, hypercholesterolemia, hyperglycaemia, renal insufficiency and a composite variable of any NCD. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazard modelling. Among a subset of participants with biomarker data, we assessed the interaction between viral load and 13 biomarkers in the association with any NCD.

resultsFrom 23 January 2013 to 1 December 2022, 1755 participants met the inclusion criteria for these analyses. At the first eligible visit, the majority of participants had an undetectable viral load (n = 1375, 78.35%). Participants with pLLV had an increased rate of developing any NCD (aHR: 1.22, 95% CI: 1.02-1.47) compared to participants with an undetectable viral load. There was a statistically significant interaction between LLV and TNF-α, CCL2/MCP-1 and TNF-RII in the association with any NCD.

conclusionsPLLV was significantly associated with NCDs and immune inflammation in this population. Aggressive management of LLV may positively impact NCDs in PLWH.

Indexed as

HIV InfectionsViremiaAdultCohort StudiesComorbidityFemaleHumansMaleMiddle AgedNoncommunicable DiseasesUgandaViral LoadYoung Adultcohort studiesHIVlow‐level viraemiamultimorbiditynon‐communicable diseasessub‐Saharan Africa

Identifiers

PMID39189824
PMCPMC11348500

What OpenQuestion holds

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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.