Evidence map›Paper›PMID 40268134›Full record

Trial reportInternational journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases2025

Risk of severe bacterial infections including TB before and after immediate or deferred antiretroviral therapy: A multicenter, prospective, cohort study.

Tomas O Jensen, Shweta Sharma, Anchalee Avihingsanon, Joseph Lutaakome, Indira Brar, William Burman, Ploenchan Chetchotisakd, Nathalie de Castro, Juan-Francisco Galán-Herrera, Nagalingeswaran Kumarasamy and 8 more

Abstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

18 authors.

Tomas O JensenCentre of Excellence for Health, Immunity, and Infections, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. Electronic address: tomas.jensen@regionh.dk.
Shweta SharmaDivision of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.
Anchalee AvihingsanonThai Red Cross AIDS Research Centre, Bangkok, Thailand.
Joseph LutaakomeMRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda.
Indira BrarHenry Ford Hospital, Detroit, Michigan, USA.
William BurmanPublic Health Institute at Denver Public Health, Denver, Colorado, USA.
Ploenchan ChetchotisakdSrinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand.
Nathalie de CastroDepartment of Infectious Diseases, Hôpital Saint-Louis, APHP, Paris, France.
Juan-Francisco Galán-HerreraMaster in Health Sciences Program, Instituto Politécnico Nacional, Mexico City, Mexico.
Nagalingeswaran KumarasamyVoluntary Health Services, Infectious Diseases Medical Centre, Chennai Antiviral Research and Treatment, Clinical Research Site, Chennai, India.
Roger ParedesHospital Universitari Germans Trias i Pujol, Barcelona, Spain.
Rene RidzonNational Institute of Allergy and Infectious Diseases, Bethesda, Maryland, USA.
Michael SciaudoneDivision of Infectious Diseases, Tulane University School of Medicine, New Orleans, Louisiana, USA.
Kanal SinghNational Institute of Allergy and Infectious Diseases, Bethesda, Maryland, USA.
Alison UrielNorth Manchester General Hospital, Manchester, UK.
Jens LundgrenCentre of Excellence for Health, Immunity, and Infections, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Cavan ReillyDivision of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.
Gail MatthewsThe Kirby Institute, Sydney, Australia.

Funding

International Network for Strategic Initiatives in Global HIV Trials (INSIGHT)UM1AI068641 · NIAID · UNIVERSITY OF MINNESOTA · PI NEATON, JAMES DENNIS · 2011 to 2014
$83.5M
International Network for Strategic Initiatives in Global HIV Trials (INSIGHT): STARTUM1AI120197 · NIAID · UNIVERSITY OF MINNESOTA · PI NEATON, JAMES DENNIS · 2015 to 2017
$65.1M
Extended follow-up of randomized participants in the INSIGHT START trialU01AI136780 · NIAID · UNIVERSITY OF MINNESOTA · PI GRUND, BIRGIT, REILLY, CAVAN S. · 2019 to 2024
$18.0M
NIAID NIH HHS U01 AI136780NIAID NIH HHS UM1 AI068641NIAID NIH HHS UM1 AI120197
6 · The paper itself

Abstract

objectivesDeferring antiretroviral therapy (ART) until a CD4 count below cells/mm

methodsWe analyzed 4684 adult PWH with CD4 cell counts above 500 cells/mm

resultsA total of 217 (4.6%) participants experienced a severe bacterial infection during the entire follow-up period. Pre-2016, the immediate group had a lower rate of severe bacterial infections compared to the deferred group (hazard ratio [HR] 0.38; 95% CI 0.26, 0.55). During 2016-2021, there was no longer a statistically significant difference (HR 0.75; 95% CI 0.49, 1.16). No differences were observed between clinical or demographic subgroups.

conclusionThe increased risk of severe bacterial infections seen after deferring ART is reversed once ART is initiated.

Indexed as

Anti-HIV AgentsAnti-Retroviral AgentsBacterial InfectionsHIV InfectionsTuberculosisAdultCD4 Lymphocyte CountFemaleHumansMaleMiddle AgedProportional Hazards ModelsProspective StudiesRisk FactorsTime-to-TreatmentAnti-HIV AgentsAnti-Retroviral AgentsAnti-retroviral agentsBacterialBacterial infectionsHIVPneumoniaTuberculosis

Identifiers

PMID40268134
PMCPMC12158625

What OpenQuestion holds

Textmetadata
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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.