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Detection of immunological treatment failure among HIV infected patients in Ethiopia: a retrospective cohort study

Overview of attention for article published in BMC Immunology, September 2015
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Title
Detection of immunological treatment failure among HIV infected patients in Ethiopia: a retrospective cohort study
Published in
BMC Immunology, September 2015
DOI 10.1186/s12865-015-0120-1
Pubmed ID
Authors

Wondu Teshome, Ambachew Tefera

Abstract

Timely detection of treatment failure with subsequent switch to second-line regimen reduces mortality among HIV infected people on antiretroviral therapy (ART). This paper aims to investigate the detection of immunological treatment failure and switch rate to second line regimen in Ethiopia. A retrospective cohort study was conducted among HIV infected patients (age > 15 years) who initiated ART between 2007 and 2009. The required data were collected from patient registers and formats. Data were entered and validated using EpiData software and then exported to SPSS version 20.0 for analysis. Odds ratio with 95 % CI was used to assess whether immunological treatment failure was associated with experiencing unfavorable treatment outcomes (death or lost to follow up). Records of 293 patients were reviewed with a total of 1545 Person-Years of Observation (PYO). The median baseline CD4 count was 115 cells/mm(3) (IQR: 64-176). A total of 46 (15.7 %) patients experienced immunological treatment failure. The immunological failure rate was 3.0 per 100 PYO. Treatment was switched to second-line regimen for six (2.1 %) patients. The rate of treatment switch to second-line regimen for any purpose was 0.4 per 100 PYO. Out of the six patients, only two fulfilled the WHO criteria for immunological failure; the remaining four patients had their treatment switched to second-line regimen for other purposes. This implies that only 4.3 % (2/46) of patients with immunological failure were switched to second-line regimen. The risk of experiencing unfavorable outcome was 5.75 (95 % CI 1.11, 29.8) times higher among those who had immunological failure than their counterparts after adjusting for baseline CD4 count. Majority of patients with immunological treatment failures were not detected and continued taking the failed regimen. Further studies are required to assess and explore why patients with immunological failure are not switched to second-line regimen as per the standard protocol.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 47 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Belgium 1 2%
Unknown 46 98%

Demographic breakdown

Readers by professional status Count As %
Researcher 9 19%
Student > Master 9 19%
Student > Bachelor 4 9%
Student > Doctoral Student 3 6%
Student > Postgraduate 3 6%
Other 9 19%
Unknown 10 21%
Readers by discipline Count As %
Medicine and Dentistry 18 38%
Nursing and Health Professions 5 11%
Biochemistry, Genetics and Molecular Biology 4 9%
Immunology and Microbiology 4 9%
Social Sciences 2 4%
Other 3 6%
Unknown 11 23%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 2. 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 12 October 2015.
All research outputs
#14,175,907
of 22,829,083 outputs
Outputs from BMC Immunology
#268
of 587 outputs
Outputs of similar age
#125,803
of 245,085 outputs
Outputs of similar age from BMC Immunology
#9
of 14 outputs
Altmetric has tracked 22,829,083 research outputs across all sources so far. This one is in the 37th percentile – i.e., 37% of other outputs scored the same or lower than it.
So far Altmetric has tracked 587 research outputs from this source. They receive a mean Attention Score of 3.7. This one has gotten more attention than average, scoring higher than 54% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 245,085 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 48th percentile – i.e., 48% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 14 others from the same source and published within six weeks on either side of this one. This one is in the 35th percentile – i.e., 35% of its contemporaries scored the same or lower than it.