A systematic review of the effectiveness of non- health facility based care delivery of antiretroviral therapy for people living with HIV in sub-Saharan Africa measured by viral suppression, mortality and retention on ART.
A systematic review of the effectiveness of non- health facility based care delivery of antiretroviral therapy for people living with HIV in sub-Saharan Africa measured by viral suppression, mortality and retention on ART.
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DOI：
10.1186/s12889-021-11053-8
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发表时间：
2021-06-10
影响因子：
4.5
通讯作者：
Fidler S
中科院分区：
文献类型：
--
作者：
Limbada M;Zijlstra G;Macleod D;Ayles H;Fidler S
可持续抗逆转录病毒治疗 (ART) 提供的替代模式对于满足撒哈拉以南非洲地区所有艾滋病毒感染者 (PLHIV) 维持全民抗逆转录病毒疗法日益增长的需求是必要的。我们对已发表的文献进行了回顾，比较了基于医疗机构的护理 (HFBC) 和基于非医疗机构的护理 (nHFBC) 的 ART 模式在健康结果方面的情况；病毒抑制、失访、保留和死亡率。我们从 2010 年起对 Medline、Embase 和 Global Health 数据库进行了系统检索。审查了联合国艾滋病规划署的报告、世界卫生组织的指南和会议摘要。所有研究至少测量以下结果之一：病毒载量抑制、失访（LTFU）和死亡率。提取数据并进行描述性分析。所有研究均进行了偏倚风险评估。使用随机效应荟萃分析对风险差异（病毒抑制）和风险比（死亡率）进行汇总估计。在 3082 条非重复记录中，有 193 条符合全文筛选条件，其中 21 篇发表的论文符合纳入标准。 4 项随机对照试验中病毒载量抑制的汇总风险差异显示，没有证据表明 nHFBC 和 HFBC 之间的病毒抑制 (VS) 存在差异，总体估计风险差异为 1% [95% CI -1, 4%]。 2 项 RCT 和 4 项观察性队列研究的死亡率汇总风险比显示，没有证据表明 nHFBC 和 HFBC 之间的死亡率存在差异，总体估计风险比为 1.01 [95% CI 0.88, 1.16]。 15 项研究包含 LTFU 数据，13 项研究包含保留数据。尽管由于论文之间的定义截然不同，没有对这些结果进行正式的定量分析，但据观察，HFBC 和 nHFBC 之间的结果似乎相似。对当前文献的回顾表明，nHFBC 与 HFBC ART 交付计划在病毒抑制、保留和死亡率方面的结果相当。 CRD42018088194。在线版本包含可在 10.1186/s12889-021-11053-8 获取的补充材料。
Alternative models for sustainable antiretroviral treatment (ART) delivery are necessary to meet the increasing demand to maintain population-wide ART for all people living with HIV (PLHIV) in sub-Saharan Africa. We undertook a review of published literature comparing health facility-based care (HFBC) with non-health facility based care (nHFBC) models of ART delivery in terms of health outcomes; viral suppression, loss to follow-up, retention and mortality. We conducted a systematic search of Medline, Embase and Global Health databases from 2010 onwards. UNAIDS reports, WHO guidelines and abstracts from conferences were reviewed. All studies measuring at least one of the following outcomes, viral load suppression, loss-to-follow-up (LTFU) and mortality were included. Data were extracted, and a descriptive analysis was performed. Risk of bias assessment was done for all studies. Pooled estimates of the risk difference (for viral suppression) and hazard ratio (for mortality) were made using random-effects meta-analysis. Of 3082 non-duplicate records, 193 were eligible for full text screening of which 21 published papers met the criteria for inclusion. The pooled risk difference of viral load suppression amongst 4 RCTs showed no evidence of a difference in viral suppression (VS) between nHFBC and HFBC with an overall estimated risk difference of 1% [95% CI -1, 4%]. The pooled hazard ratio of mortality amongst 2 RCTs and 4 observational cohort studies showed no evidence of a difference in mortality between nHFBC and HFBC with an overall estimated hazard ratio of 1.01 [95% CI 0.88, 1.16]. Fifteen studies contained data on LTFU and 13 studies on retention. Although no formal quantitative analysis was performed on these outcomes due to the very different definitions between papers, it was observed that the outcomes appeared similar between HFBC and nHFBC. Review of current literature demonstrates comparable outcomes for nHFBC compared to HFBC ART delivery programmes in terms of viral suppression, retention and mortality. CRD42018088194. The online version contains supplementary material available at 10.1186/s12889-021-11053-8.
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DOI：
10.1097/qai.0000000000000553
发表时间：
2015-05-01
期刊：
Journal of acquired immune deficiency syndromes (1999)
影响因子：
--
作者：
Fox MP;Rosen S
通讯作者：
Rosen S
DOI：
10.1056/nejmoa1600693
发表时间：
2016-09-01
期刊：
The New England journal of medicine
影响因子：
--
作者：
Cohen MS;Chen YQ;McCauley M;Gamble T;Hosseinipour MC;Kumarasamy N;Hakim JG;Kumwenda J;Grinsztejn B;Pilotto JH;Godbole SV;Chariyalertsak S;Santos BR;Mayer KH;Hoffman IF;Eshleman SH;Piwowar-Manning E;Cottle L;Zhang XC;Makhema J;Mills LA;Panchia R;Faesen S;Eron J;Gallant J;Havlir D;Swindells S;Elharrar V;Burns D;Taha TE;Nielsen-Saines K;Celentano DD;Essex M;Hudelson SE;Redd AD;Fleming TR;HPTN 052 Study Team
通讯作者：
HPTN 052 Study Team
影响因子：
15.8
作者：
Geldsetzer, Pascal;Francis, Joel M.;Baernighausen, Till
通讯作者：
Baernighausen, Till
影响因子：
158.5
作者：
Danel, Christine;Moh, Raoul;Anglaret, Xavier
通讯作者：
Anglaret, Xavier
影响因子：
2.8
作者：
Geldsetzer, Pascal;Francis, Joel M.;Barnighausen, Till
通讯作者：
Barnighausen, Till