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

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 (2020). International epidemiology databases to evaluate AIDS (IeDEA) in sub-Saharan Africa, 2012-2019. BMJ open, 10(5), e035246. BMJ Publishing Group 10.1136/bmjopen-2019-035246

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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.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)

UniBE Contributor:

Chammartin, Frédérique Sophie; Dao Ostinelli, Cam Ha; von Groote, Per Maximilian and Egger, Matthias

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

2044-6055

Publisher:

BMJ Publishing Group

Funders:

[4] Swiss National Science Foundation

Language:

English

Submitter:

Andrea Flükiger-Flückiger

Date Deposited:

19 May 2020 12:06

Last Modified:

12 May 2021 13:46

Publisher DOI:

10.1136/bmjopen-2019-035246

PubMed ID:

32414825

Uncontrolled Keywords:

HIV & AIDS epidemiology infectious diseases tuberculosis

BORIS DOI:

10.7892/boris.144166

URI:

https://boris.unibe.ch/id/eprint/144166

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