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Is laboratory screening prior to antiretroviral treatment useful in Johannesburg, South Africa? Baseline findings of a clinical trial

Overview of attention for article published in BMC Public Health, July 2017
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Title
Is laboratory screening prior to antiretroviral treatment useful in Johannesburg, South Africa? Baseline findings of a clinical trial
Published in
BMC Public Health, July 2017
DOI 10.1186/s12889-017-4353-1
Pubmed ID
Authors

Willem D. F. Venter, Mohammed Majam, Godspower Akpomiemie, Natasha Arulappan, Michelle Moorhouse, Nonkululeko Mashabane, Matthew F. Chersich

Abstract

Screening for renal, hepatic and haematological disorders complicates the initiation of current first-line antiretroviral therapy (ART). Each additional test done adds substantial costs, both through direct laboratory expenses, but also by increasing the burden on health workers and patients. Evaluating the prevalence of clinically relevant abnormalities in different population groups could guide decisions about what tests to recommend in national guidelines, or in local adaptations of these. As part of enrolment procedures in a clinical trial, 771 HIV-positive adults, predominantly from inner-city primary health care clinics, underwent laboratory screening prior to ART. Participants had to be eligible for ART, based on the then CD4 eligibility threshold of 350 cells/μL, antiretroviral naïve and have no symptoms of peripheral neuropathy. Participants were mostly female (57%) and a mean 34 years old. Creatinine clearance rates were almost all above 50 mL/min (99%), although 5% had microalbuminuria. Hepatitis B antigenaemia was common (8% of participants), of whom 40% had a raised AST/ALT, though only 2 had transaminase levels above 200 IU/L. Only 2% of participants had severe anaemia (haemoglobin <8 g/dl) and 1% neutropaenia (neutrophils <0.75 × 10^9/L). Costs per case detected of hepatitis B infection was USD135, but more than USD800 for a raised creatinine. Hepatitis B continues to be a common co-infection in HIV-infected adults, and adds complexity to management of ART switches involving tenofovir. Routine renal and haematological screening prior to ART detected few abnormalities. The use of these screening tests should be assessed among patients with higher CD4 counts, who may even have fewer abnormalities. Formal evaluation of cost-effectiveness of laboratory screening prior to ART is warranted.

Twitter Demographics

The data shown below were collected from the profile of 1 tweeter who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 91 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 91 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 17 19%
Student > Master 16 18%
Student > Bachelor 10 11%
Student > Postgraduate 7 8%
Student > Ph. D. Student 6 7%
Other 12 13%
Unknown 23 25%
Readers by discipline Count As %
Medicine and Dentistry 26 29%
Nursing and Health Professions 11 12%
Agricultural and Biological Sciences 6 7%
Economics, Econometrics and Finance 4 4%
Pharmacology, Toxicology and Pharmaceutical Science 3 3%
Other 15 16%
Unknown 26 29%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 11 August 2017.
All research outputs
#10,287,906
of 11,598,144 outputs
Outputs from BMC Public Health
#7,476
of 7,977 outputs
Outputs of similar age
#223,657
of 265,092 outputs
Outputs of similar age from BMC Public Health
#140
of 148 outputs
Altmetric has tracked 11,598,144 research outputs across all sources so far. This one is in the 1st percentile – i.e., 1% of other outputs scored the same or lower than it.
So far Altmetric has tracked 7,977 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 10.2. This one is in the 1st percentile – i.e., 1% of its peers scored the same or lower than it.
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We're also able to compare this research output to 148 others from the same source and published within six weeks on either side of this one. This one is in the 1st percentile – i.e., 1% of its contemporaries scored the same or lower than it.