Empiric Deworming and CD4 Count Recovery in HIV-Infected Ugandans Initiating Antiretroviral Therapy
Publication Date
August 07, 2014
Journal
PLOS Neglected Tropical Diseases
Authors
Alexander J. Lankowski, Alexander C. Tsai, Michael Kanyesigye, Mwebesa Bwana, et al
Volume
8
Issue
8
Pages
e3036
DOI
https://dx.plos.org/10.1371/journal.pntd.0003036
Publisher URL
http://journals.plos.org/plosntds/article?id=10.1371%2Fjournal.pntd.0003036
PubMed
http://www.ncbi.nlm.nih.gov/pubmed/25101890
PubMed Central
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4125278
Europe PMC
http://europepmc.org/abstract/MED/25101890
Web of Science
000341574700020
Scopus
84923278235
Mendeley
http://www.mendeley.com/research/empiric-deworming-cd4-count-recovery-hivinfected-ugandans-initiating-antiretroviral-therapy
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Mendeley | Further Information

{"title"=>"Empiric Deworming and CD4 Count Recovery in HIV-Infected Ugandans Initiating Antiretroviral Therapy", "type"=>"journal", "authors"=>[{"first_name"=>"Alexander J.", "last_name"=>"Lankowski", "scopus_author_id"=>"14068651400"}, {"first_name"=>"Alexander C.", "last_name"=>"Tsai", "scopus_author_id"=>"35362700200"}, {"first_name"=>"Michael", "last_name"=>"Kanyesigye", "scopus_author_id"=>"56711261200"}, {"first_name"=>"Mwebesa", "last_name"=>"Bwana", "scopus_author_id"=>"12796974700"}, {"first_name"=>"Jessica E.", "last_name"=>"Haberer", "scopus_author_id"=>"7101804832"}, {"first_name"=>"Megan", "last_name"=>"Wenger", "scopus_author_id"=>"56548411500"}, {"first_name"=>"Jeffrey N.", "last_name"=>"Martin", "scopus_author_id"=>"7501562043"}, {"first_name"=>"David R.", "last_name"=>"Bangsberg", "scopus_author_id"=>"7005550791"}, {"first_name"=>"Peter W.", "last_name"=>"Hunt", "scopus_author_id"=>"7202324398"}, {"first_name"=>"Mark J.", "last_name"=>"Siedner", "scopus_author_id"=>"16235029000"}], "year"=>2014, "source"=>"PLoS Neglected Tropical Diseases", "identifiers"=>{"pui"=>"607876839", "sgr"=>"84923278235", "issn"=>"19352735", "pmid"=>"25101890", "scopus"=>"2-s2.0-84923278235", "doi"=>"10.1371/journal.pntd.0003036", "isbn"=>"1935-2735 (Electronic)\\r1935-2727 (Linking)"}, "id"=>"55dfba0f-56fa-3055-9cef-fd41c259ff32", "abstract"=>"BACKGROUND There is conflicting evidence on the immunologic benefit of treating helminth co-infections (\"deworming\") in HIV-infected individuals. Several studies have documented reduced viral load and increased CD4 count in antiretroviral therapy (ART) naïve individuals after deworming. However, there are a lack of data on the effect of deworming therapy on CD4 count recovery among HIV-infected persons taking ART. METHODOLOGY/PRINCIPAL FINDINGS To estimate the association between empiric deworming therapy and CD4 count after ART initiation, we performed a retrospective observational study among HIV-infected adults on ART at a publicly operated HIV clinic in southwestern Uganda. Subjects were assigned as having received deworming if prescribed an anti-helminthic agent between 7 and 90 days before a CD4 test. To estimate the association between deworming and CD4 count, we fit multivariable regression models and analyzed predictors of CD4 count, using a time-by-interaction term with receipt or non-receipt of deworming. From 1998 to 2009, 5,379 subjects on ART attended 21,933 clinic visits at which a CD4 count was measured. Subjects received deworming prior to 668 (3%) visits. Overall, deworming was not associated with a significant difference in CD4 count in either the first year on ART (β = 42.8; 95% CI, -2.1 to 87.7) or after the first year of ART (β = -9.9; 95% CI, -24.1 to 4.4). However, in a sub-analysis by gender, during the first year of ART deworming was associated with a significantly greater rise in CD4 count (β = 63.0; 95% CI, 6.0 to 120.1) in females. CONCLUSIONS/SIGNIFICANCE Empiric deworming of HIV-infected individuals on ART conferred no significant generalized benefit on subsequent CD4 count recovery. A significant association was observed exclusively in females and during the initial year on ART. Our findings are consistent with recent studies that failed to demonstrate an immunologic advantage to empirically deworming ART-naïve individuals, but suggest that certain sub-populations may benefit.", "link"=>"http://www.mendeley.com/research/empiric-deworming-cd4-count-recovery-hivinfected-ugandans-initiating-antiretroviral-therapy", "reader_count"=>18, "reader_count_by_academic_status"=>{"Researcher"=>5, "Student > Doctoral Student"=>1, "Student > Ph. D. Student"=>4, "Student > Postgraduate"=>1, "Student > Master"=>2, "Other"=>3, "Lecturer"=>1, "Professor"=>1}, "reader_count_by_user_role"=>{"Researcher"=>5, "Student > Doctoral Student"=>1, "Student > Ph. D. Student"=>4, "Student > Postgraduate"=>1, "Student > Master"=>2, "Other"=>3, "Lecturer"=>1, "Professor"=>1}, "reader_count_by_subject_area"=>{"Unspecified"=>1, "Biochemistry, Genetics and Molecular Biology"=>1, "Agricultural and Biological Sciences"=>3, "Medicine and Dentistry"=>9, "Social Sciences"=>3, "Immunology and Microbiology"=>1}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>9}, "Social Sciences"=>{"Social Sciences"=>3}, "Immunology and Microbiology"=>{"Immunology and Microbiology"=>1}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>3}, "Biochemistry, Genetics and Molecular Biology"=>{"Biochemistry, Genetics and Molecular Biology"=>1}, "Unspecified"=>{"Unspecified"=>1}}, "reader_count_by_country"=>{"United Kingdom"=>1}, "group_count"=>2}

Scopus | Further Information

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Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/1626359"], "description"=>"†<p>Predicted difference in body mass or blood hemoglobin concentration between patients receiving versus not receiving deworming therapy in the past 90 days.</p>", "links"=>[], "tags"=>["immunology", "microbiology", "epidemiology", "Infectious diseases", "Public and occupational health", "Global health", "multivariable", "linear", "regression", "modeling", "predictors", "hemoglobin"], "article_id"=>1131483, "categories"=>["Biological Sciences"], "users"=>["Alexander J. Lankowski", "Alexander C. Tsai", "Michael Kanyesigye", "Mwebesa Bwana", "Jessica E. Haberer", "Megan Wenger", "Jeffrey N. Martin", "David R. Bangsberg", "Peter W. Hunt", "Mark J. Siedner"], "doi"=>"https://dx.doi.org/10.1371/journal.pntd.0003036.t004", "stats"=>{"downloads"=>0, "page_views"=>2, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Secondary_analysis_multivariable_linear_regression_modeling_of_predictors_of_body_mass_and_blood_hemoglobin_concentration_/1131483", "title"=>"Secondary analysis: multivariable linear regression modeling of predictors of body mass and blood hemoglobin concentration.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-08-07 03:15:01"}
  • {"files"=>["https://ndownloader.figshare.com/files/1626358"], "description"=>"†<p>Predicted difference in CD4 count between patients receiving versus not receiving deworming therapy in the past 90 days. The interaction terms were separated by duration of prior ART use as up to 1 year of therapy versus greater than 1 year of therapy.</p>", "links"=>[], "tags"=>["immunology", "microbiology", "epidemiology", "Infectious diseases", "Public and occupational health", "Global health", "linear", "regression", "predictors", "cd4", "stratified"], "article_id"=>1131482, "categories"=>["Biological Sciences"], "users"=>["Alexander J. Lankowski", "Alexander C. Tsai", "Michael Kanyesigye", "Mwebesa Bwana", "Jessica E. Haberer", "Megan Wenger", "Jeffrey N. Martin", "David R. Bangsberg", "Peter W. Hunt", "Mark J. Siedner"], "doi"=>"https://dx.doi.org/10.1371/journal.pntd.0003036.t003", "stats"=>{"downloads"=>0, "page_views"=>9, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Multivariable_linear_regression_model_of_predictors_of_CD4_count_stratified_by_gender_n_8202_8202_5379_/1131482", "title"=>"Multivariable linear regression model of predictors of CD4 count, stratified by gender (n = 5379).", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-08-07 03:15:01"}
  • {"files"=>["https://ndownloader.figshare.com/files/1626360"], "description"=>"<div><p>Background</p><p>There is conflicting evidence on the immunologic benefit of treating helminth co-infections (“deworming”) in HIV-infected individuals. Several studies have documented reduced viral load and increased CD4 count in antiretroviral therapy (ART) naïve individuals after deworming. However, there are a lack of data on the effect of deworming therapy on CD4 count recovery among HIV-infected persons taking ART.</p><p>Methodology/Principal Findings</p><p>To estimate the association between empiric deworming therapy and CD4 count after ART initiation, we performed a retrospective observational study among HIV-infected adults on ART at a publicly operated HIV clinic in southwestern Uganda. Subjects were assigned as having received deworming if prescribed an anti-helminthic agent between 7 and 90 days before a CD4 test. To estimate the association between deworming and CD4 count, we fit multivariable regression models and analyzed predictors of CD4 count, using a time-by-interaction term with receipt or non-receipt of deworming. From 1998 to 2009, 5,379 subjects on ART attended 21,933 clinic visits at which a CD4 count was measured. Subjects received deworming prior to 668 (3%) visits. Overall, deworming was not associated with a significant difference in CD4 count in either the first year on ART (β = 42.8; 95% CI, −2.1 to 87.7) or after the first year of ART (β = −9.9; 95% CI, −24.1 to 4.4). However, in a sub-analysis by gender, during the first year of ART deworming was associated with a significantly greater rise in CD4 count (β = 63.0; 95% CI, 6.0 to 120.1) in females.</p><p>Conclusions/Significance</p><p>Empiric deworming of HIV-infected individuals on ART conferred no significant generalized benefit on subsequent CD4 count recovery. A significant association was observed exclusively in females and during the initial year on ART. Our findings are consistent with recent studies that failed to demonstrate an immunologic advantage to empirically deworming ART-naïve individuals, but suggest that certain sub-populations may benefit.</p></div>", "links"=>[], "tags"=>["immunology", "microbiology", "epidemiology", "Infectious diseases", "Public and occupational health", "Global health", "deworming", "cd4", "hiv-infected", "ugandans", "initiating", "antiretroviral"], "article_id"=>1131484, "categories"=>["Biological Sciences"], "users"=>["Alexander J. Lankowski", "Alexander C. Tsai", "Michael Kanyesigye", "Mwebesa Bwana", "Jessica E. Haberer", "Megan Wenger", "Jeffrey N. Martin", "David R. Bangsberg", "Peter W. Hunt", "Mark J. Siedner"], "doi"=>"https://dx.doi.org/10.1371/journal.pntd.0003036", "stats"=>{"downloads"=>1, "page_views"=>19, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Empiric_Deworming_and_CD4_Count_Recovery_in_HIV_Infected_Ugandans_Initiating_Antiretroviral_Therapy_/1131484", "title"=>"Empiric Deworming and CD4 Count Recovery in HIV-Infected Ugandans Initiating Antiretroviral Therapy", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-08-07 03:15:01"}
  • {"files"=>["https://ndownloader.figshare.com/files/1626355"], "description"=>"<p>*100000 Uganda shillings valued at approximately 40 USD as of April 1, 2014.</p>", "links"=>[], "tags"=>["immunology", "microbiology", "epidemiology", "Infectious diseases", "Public and occupational health", "Global health"], "article_id"=>1131479, "categories"=>["Biological Sciences"], "users"=>["Alexander J. Lankowski", "Alexander C. Tsai", "Michael Kanyesigye", "Mwebesa Bwana", "Jessica E. Haberer", "Megan Wenger", "Jeffrey N. Martin", "David R. Bangsberg", "Peter W. Hunt", "Mark J. Siedner"], "doi"=>"https://dx.doi.org/10.1371/journal.pntd.0003036.t001", "stats"=>{"downloads"=>0, "page_views"=>3, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Subject_characteristics_/1131479", "title"=>"Subject characteristics.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-08-07 03:15:01"}
  • {"files"=>["https://ndownloader.figshare.com/files/1626356"], "description"=>"†<p>Predicted difference in CD4 count between patients receiving versus not receiving deworming therapy in the past 90 days. The interaction terms were separated by duration of prior ART use as up to 1 year of therapy versus greater than 1 year of therapy.</p>", "links"=>[], "tags"=>["immunology", "microbiology", "epidemiology", "Infectious diseases", "Public and occupational health", "Global health", "multivariable", "linear", "regression", "predictors", "cd4"], "article_id"=>1131480, "categories"=>["Biological Sciences"], "users"=>["Alexander J. Lankowski", "Alexander C. Tsai", "Michael Kanyesigye", "Mwebesa Bwana", "Jessica E. Haberer", "Megan Wenger", "Jeffrey N. Martin", "David R. Bangsberg", "Peter W. Hunt", "Mark J. Siedner"], "doi"=>"https://dx.doi.org/10.1371/journal.pntd.0003036.t002", "stats"=>{"downloads"=>0, "page_views"=>6, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Primary_analysis_multivariable_linear_regression_model_of_predictors_of_CD4_count_n_8202_8202_5379_/1131480", "title"=>"Primary analysis: multivariable linear regression model of predictors of CD4 count (n = 5379).", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-08-07 03:15:01"}
  • {"files"=>["https://ndownloader.figshare.com/files/1626354"], "description"=>"<p>Predicted values are based on the multivariable linear regression model <b>y = α+β<sub>1</sub>t+β<sub>2</sub>t+β<sub>3</sub>t+β<sub>4</sub>t</b>, where the independent variable, <i>y</i>, is CD4 count; the dependent variable, <i>t</i>, is time on ART, the <i>y</i>-intercept, α, is CD4 count at <i>t</i> = 0, and <b>β<sub>1</sub></b>–<b>β<sub>4</sub></b> are respective <b>β</b>-coefficients for the co-variables age, TB co-infection, deworming, and deworming*time interaction.</p>", "links"=>[], "tags"=>["immunology", "microbiology", "epidemiology", "Infectious diseases", "Public and occupational health", "Global health", "cd4"], "article_id"=>1131478, "categories"=>["Biological Sciences"], "users"=>["Alexander J. Lankowski", "Alexander C. Tsai", "Michael Kanyesigye", "Mwebesa Bwana", "Jessica E. Haberer", "Megan Wenger", "Jeffrey N. Martin", "David R. Bangsberg", "Peter W. Hunt", "Mark J. Siedner"], "doi"=>"https://dx.doi.org/10.1371/journal.pntd.0003036.g001", "stats"=>{"downloads"=>0, "page_views"=>3, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Predicted_CD4_count_by_time_on_ART_/1131478", "title"=>"Predicted CD4 count by time on ART.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-08-07 03:15:01"}

PMC Usage Stats | Further Information

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  • {"unique-ip"=>"10", "full-text"=>"13", "pdf"=>"1", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"9"}
  • {"unique-ip"=>"18", "full-text"=>"21", "pdf"=>"1", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"10"}
  • {"unique-ip"=>"15", "full-text"=>"16", "pdf"=>"0", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"11"}
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  • {"unique-ip"=>"1", "full-text"=>"1", "pdf"=>"0", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"2"}
  • {"unique-ip"=>"8", "full-text"=>"9", "pdf"=>"1", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"3"}
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Relative Metric

{"start_date"=>"2014-01-01T00:00:00Z", "end_date"=>"2014-12-31T00:00:00Z", "subject_areas"=>[{"subject_area"=>"/Biology and life sciences/Biochemistry", "average_usage"=>[282]}, {"subject_area"=>"/Biology and life sciences/Microbiology", "average_usage"=>[317]}, {"subject_area"=>"/Medicine and health sciences", "average_usage"=>[285]}, {"subject_area"=>"/Medicine and health sciences/Immunology", "average_usage"=>[289]}, {"subject_area"=>"/Medicine and health sciences/Infectious diseases", "average_usage"=>[319]}, {"subject_area"=>"/Medicine and health sciences/Parasitic diseases", "average_usage"=>[418, 848]}, {"subject_area"=>"/Medicine and health sciences/Public and occupational health", "average_usage"=>[327, 510]}]}
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