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International epidemiology databases to evaluate AIDS (IeDEA) in sub-Saharan Africa, 2012–2019

Type of publication Peer-reviewed
Publikationsform Original article (peer-reviewed)
Author Chammartin Frédérique, Dao Ostinelli Cam Ha, Anastos Kathryn, Jaquet Antoine, Brazier Ellen, Brown Steven, Dabis Francois, Davies Mary-Ann, Duda Stephany N, Malateste Karen, Nash Denis, Wools-Kaloustian Kara, von Groote Per M, Egger Matthias,
Project Forschungspauschale Forschungsratspräsident SNF
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Original article (peer-reviewed)

Journal BMJ Open
Volume (Issue) 10(5)
Page(s) e035246 - e035246
Title of proceedings BMJ Open
DOI 10.1136/bmjopen-2019-035246

Open Access

URL https://bmjopen.bmj.com/content/10/5/e035246
Type of Open Access Publisher (Gold Open Access)

Abstract

PurposeThe 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.ParticipantsIeDEA 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 dateThe 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 plansIeDEA 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.
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