Adult mortality and antiretroviral treatment roll-out in rural KwaZulu-Natal, South Africa

Herbst, Abraham J; Cooke, Graham; Bärnighausen, Till; KanyKany, Angelique; Tanser, Frank; Newell, Marie‐Louise

doi:10.2471/blt.08.058982

Cited by 148 publications

(175 citation statements)

References 32 publications

(40 reference statements)

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“…HIV-NHL were on c-ART, as the "HIV-rollout" in South Africa began much later than in other areas of the world, in 2004 [7] [35]. The median CD4 count in this cohort of patients was 177ul/ml (range 8 -1002) [7].…”

Section: Clinical Presentation and Outcomementioning

confidence: 99%

The Impact of Human Immunodeficiency Virus Infection (HIV) on Lymphoma in South Africa

Patel¹,

Philip²,

Touzani³

et al. 2015

JCT

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Section: Clinical Presentation and Outcomementioning

confidence: 99%

The Impact of Human Immunodeficiency Virus Infection (HIV) on Lymphoma in South Africa

Patel¹,

Philip²,

Touzani³

et al. 2015

JCT

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“…For the 34 million people presently living with HIV, most will reach CD4 cell count levels requiring treatment initiation within this decade (as of 2011, approximately 8 million PLHIV were receiving ART, with 6.8 million still eligible) [1]. In addition, the effectiveness of ARVs is improving, substantially reducing morbidity and mortality [46][47][48][49], and simpler, less toxic ARV regimens are gradually being introduced in low-income countries.…”

Section: Retention and Adherence In The Response To Hivmentioning

confidence: 99%

Retention in Care and Adherence to ART are Critical Elements of HIV Care Interventions

et al. 2013

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Retention in care and adherence to antiretroviral treatment (ART) are critical elements of HIV care interventions and are closely associated with optimal individual and public health outcomes and cost effectiveness. This literature review was conducted to analyse how the roles of clients in HIV care and treatment are discussed, from terminology used to measurement methods to consequences of a wide range of patient-related factors impacting client adherence to ART and retention in care. Unfortunately, data suggests that clients find it hard to follow recommended behaviour. For HIV, the greatest loss to follow-up occurs before starting treatment, though each step of the continuum of care is affected. Measurement approaches can be divided into 'direct' and 'indirect' methods; in practice, a combination is often considered the best strategy. Inadequate retention and adherence lead to decreased health outcomes (morbidity, mortality, drug resistances, risk of transmission) and cost effectiveness (increased costs and lower productivity).

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“…Approximately 9.7 million people now receive ART in low-and middle-income countries, representing a 32-fold increase over the last decade [1]. Effective ART reduces viral load (VL) to undetectable levels and dramatically reduces associated mortality and morbidity [2][3][4]. As a public health intervention, ART is at the core of a treatment-as-prevention strategy, as reducing community viral load reduces HIV transmissions [4].…”

Section: Introductionmentioning

confidence: 99%

Head to head comparisons in performance of CD4 point-of-care assays: a Bayesian meta-analysis (2000–2013)

Pai

Wilkinson

Chiavegatti

et al. 2014

ScienceOpen Research

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Timely detection, staging, and treatment initiation are pertinent to controlling HIV infection. CD4+ cell-based point-of-care (POC) devices offer the potential to rapidly stage patients, and decide on initiating treatment, but a comparative evaluation of their performance has not yet been performed. With this in mind, we conducted a systematic review and metaanalyses. For the period January 2000 to April 2014, 19 databases were systematically searched, 6619 citations retrieved, and 25 articles selected. Diagnostic performance was compared across devices (i.e., PIMA, CyFlow, miniPOC, MBioCD4 System) and across specimens (i.e., capillary blood vs. venous blood). A Bayesian approach was used to meta-analyze the data. The primary outcome, the Bland-Altman (BA) mean bias (which represents agreement between cell counts from POC device and flow cytometry), was analyzed with a Bayesian hierarchical normal model. We performed a headto-head comparison of two POC devices including the PIMA and PointCareNOW CD4. PIMA appears to perform better vs. PointCareNOW with venous samples (BA mean bias: -9.5 cells/μL; 95% CrI: -37.71 to 18.27, vs. 139.3 cells/μL; 95% CrI: -0.85 to 267.4, mean difference = 148.8, 95% CrI: 11.8, 285.8); importantly, PIMA performed well when used with capillary samples (BA mean bias: 2.2 cells/μL; 95% CrI: -19.32 to 23.6). Sufficient data were available to allow pooling of sensitivity and specificity data only at the 350 cells/μL cutoff. For PIMA device sensitivity 91.6 (84.7-95.5) and specificity was 94.8 (90.1-97.3), respectively. There were not sufficient data to allow comparisons between any other devices. PIMA device was comparable to flow cytometry. The estimated differences between the CD4+ cell counts of the device and the reference was small and best estimated in capillary blood specimens. As the evidence stands, the PointCareNOW device will need to improve prior to widespread use and more data on MBio and MiniPOC are needed. Findings inform implementation of PIMA and improvements in other CD4 POC device prior to recommending widespread use.

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Adult mortality and antiretroviral treatment roll-out in rural KwaZulu-Natal, South Africa

Cited by 148 publications

References 32 publications

The Impact of Human Immunodeficiency Virus Infection (HIV) on Lymphoma in South Africa

The Impact of Human Immunodeficiency Virus Infection (HIV) on Lymphoma in South Africa

Retention in Care and Adherence to ART are Critical Elements of HIV Care Interventions

Head to head comparisons in performance of CD4 point-of-care assays: a Bayesian meta-analysis (2000–2013)

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