RT Journal Article
SR Electronic
T1 International epidemiology databases to evaluate AIDS (IeDEA) in sub-Saharan Africa, 2012–2019
JF BMJ Open
JO BMJ Open
FD British Medical Journal Publishing Group
SP e035246
DO 10.1136/bmjopen-2019-035246
VO 10
IS 5
A1 Frédérique Chammartin
A1 Cam Ha Dao Ostinelli
A1 Kathryn Anastos
A1 Antoine Jaquet
A1 Ellen Brazier
A1 Steven Brown
A1 Francois Dabis
A1 Mary-Ann Davies
A1 Stephany N Duda
A1 Karen Malateste
A1 Denis Nash
A1 Kara Wools-Kaloustian
A1 Per M von Groote
A1 Matthias Egger
YR 2020
UL http://bmjopen.bmj.com/content/10/5/e035246.abstract
AB Purpose The objectives of the International epidemiology databases to evaluate AIDS (IeDEA) are to (i) evaluate the delivery of combination antiretroviral therapy (ART) in children, adolescents and adults in sub-Saharan Africa, (ii) to describe ART regimen effectiveness, durability and tolerability, (iii) to examine HIV-related comorbidities and coinfections and (iv) to examine the pregnancy-related and HIV-related outcomes of women on ART and their infants exposed to HIV or ART in utero or via breast milk.Participants IeDEA is organised in four regions (Central, East, Southern and West Africa), with 240 treatment and care sites, six data centres at African, European and US universities, and almost 1.4 million children, adolescents and adult people living with HIV (PLWHIV) enrolled.Findings to date The data include socio-demographic characteristics, clinical outcomes, opportunistic events, treatment regimens, clinic visits and laboratory measurements. They have been used to analyse outcomes in PLWHIV-1 or PLWHIV-2 who initiate ART, including determinants of mortality, of switching to second-line and third-line ART, drug resistance, loss to follow-up and the immunological and virological response to different ART regimens. Programme-level estimates of mortality have been corrected for loss to follow-up. We examined the impact of coinfection with hepatitis B and C, and the epidemiology of different cancers and of (multidrug resistant) tuberculosis, renal disease and of mental illness. The adoption of ‘Treat All’, making ART available to all PLWHIV regardless of CD4+ cell count or clinical stage was another important research topic.Future plans IeDEA has formulated several research priorities for the ‘Treat All’ era in sub-Saharan Africa. It recently obtained funding to set up sentinel sites where additional data are prospectively collected on cardiometabolic risks factors as well as mental health and liver diseases, and is planning to create a drug resistance database.