Persistent Difficulties in Switching to Second-Line ART in Sub-Saharan Africa — A Systematic Review and Meta-Analysis
| Autor: | Sandrine Leroy, Florence Huber, Marie-Anne Rey-Cuille, Yoann Madec, Alexandra Calmy |
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| Přispěvatelé: | Epidémiologie des Maladies Emergentes - Emerging Diseases Epidemiology, Pasteur-Cnam Risques infectieux et émergents (PACRI), Institut Pasteur [Paris]-Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Institut Pasteur [Paris]-Conservatoire National des Arts et Métiers [CNAM] (CNAM), Solidarité thérapeutique & initiatives contre le sida (SOLTHIS), Geneva University Hospital (HUG), The authors have no support or funding to report., Institut Pasteur [Paris] (IP)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Institut Pasteur [Paris] (IP)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM) |
| Jazyk: | angličtina |
| Rok vydání: | 2013 |
| Předmět: |
Adult
Male Sub saharan Science 030312 virology 03 medical and health sciences 0302 clinical medicine Second line [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases Antiretroviral Therapy Highly Active Medicine Humans 030212 general & internal medicine Programme level Africa South of the Sahara 0303 health sciences Multidisciplinary business.industry Incidence (epidemiology) Incidence Confidence interval 3. Good health Regimen Meta-analysis Female [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie business Viral load Demography Research Article |
| Zdroj: | PLoS ONE PLoS ONE, Public Library of Science, 2013, 8 (12), pp.e82724. ⟨10.1371/journal.pone.0082724⟩ PLoS ONE, Vol 8, Iss 12, p e82724 (2013) PLoS ONE, 2013, 8 (12), pp.e82724. ⟨10.1371/journal.pone.0082724⟩ |
| ISSN: | 1932-6203 |
| Popis: | Correction:15 Apr 2014: The PLOS ONE Staff (2014) Correction: Persistent Difficulties in Switching to Second-Line ART in Sub-Saharan Africa — A Systematic Review and Meta-Analysis. PLOS ONE 9(4): e95820. https://doi.org/10.1371/journal.pone.0095820; International audience; Objectives: Switching to second-line antiretroviral therapy (ART) largely depends on careful clinical assessment and access to biological measurements. We performed a systematic review and meta-analysis to estimate the incidence of switching to second-line ART in sub-Saharan Africa and its main programmatic determinants.Methods: We searched 2 databases for studies reporting the incidence rate of switching to second-line ART in adults living in sub-Saharan Africa. Data on the incidence rate of switching were pooled, and random-effect models were used to evaluate the effect of factors measured at the programme level on this incidence rate.Results: Nine studies (157,340 patients) in 21 countries were included in the meta-analysis. All studies considered patients under first-line ART and conditions to initiate ART were similar across studies. Overall, 3,736 (2.4%) patients switched to second-line ART. Incidence rate of switch was in mean 2.65 per 100 person-years (PY) (95% confidence interval: 2.01-3.30); it ranged from 0.42 to 4.88 per 100 PY and from 0 to 4.80 per 100 PY in programmes with and without viral load monitoring, respectively. No factors measured at the programme level were associated with the incidence rate of switching to second-line ART.Conclusion: The low incidence rate of switching to second-line ART suggests that the monitoring of patients under ART is challenging and that access to second-line ART is ineffective; efforts should be made to increase access to second-line ART to those in need by providing monitoring tools, education and training, as well as a more convenient regimen. |
| Databáze: | OpenAIRE |
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