{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T13:08:46Z","timestamp":1768568926002,"version":"3.49.0"},"posted":{"date-parts":[[2024,6,20]]},"group-title":"HIV\/AIDS","reference-count":37,"publisher":"openRxiv","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2024,6,20]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Few studies have evaluated baseline predictors of clinical outcomes among people with HIV starting antiretroviral therapy (ART) in the modern era of rapid ART initiation.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a secondary analysis of a randomized controlled trial of two rapid treatment initiation strategies for people with treatment-na\u00efve HIV and tuberculosis symptoms at an urban clinic in Haiti. We used logistic regression models to assess associations between baseline characteristics and (1) retention in care at 48 weeks, (2) HIV viral load suppression at 48 weeks (among participants who underwent viral load testing), and (3) all-cause mortality.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>500 participants were enrolled in the study 11\/2017-1\/2020. Eighty-eight (18%) participants were diagnosed with tuberculosis, and ART was started in 494 (99%). After adjustment, less than secondary education (adjusted odds ratio [AOR] 0.21, 95% CI 0.10-0.46), dolutegravir initiation (AOR 2.57, 95% CI 1.22-5.43), age (AOR 1.42 per 10-year increase, 95% CI 1.01-1.99), and tuberculosis diagnosis (AOR 3.92, 95% CI 1.36-11.28) were significantly associated with retention. Age (AOR 1.36, 95% CI 1.05-1.75), dolutegravir initiation (AOR 1.75, 95% CI 1.07-2.85), and tuberculosis diagnosis (AOR 0.50, 95% CI 0.28-0.89) were associated with viral suppression. Higher CD4 cell count at enrollment (unadjusted odds ratio [OR] 0.69, 95% CI 0.55-0.87) and anemia (OR 4.86, 95% CI 1.71-13.81) were associated with mortality.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>We identified sociodemographic, treatment-related, clinical, and laboratory-based predictors of clinical outcomes. These characteristics may serve as markers of sub- populations that could benefit from additional interventions to support treatment success after rapid treatment initiation.<\/jats:p>\n                <\/jats:sec>","DOI":"10.1101\/2024.06.19.24309189","type":"posted-content","created":{"date-parts":[[2024,6,20]],"date-time":"2024-06-20T12:10:45Z","timestamp":1718885445000},"source":"Crossref","is-referenced-by-count":2,"title":["Predictors of Clinical Outcomes among People with HIV and Tuberculosis Symptoms after Rapid Treatment Initiation in Haiti"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7920-7191","authenticated-orcid":false,"given":"Aaron","family":"Richterman","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-2435-1725","authenticated-orcid":false,"given":"Nancy","family":"Dorvil","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vanessa","family":"Rivera","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5755-9951","authenticated-orcid":false,"given":"Heejung","family":"Bang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrice","family":"Severe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kerylyne","family":"Lavoile","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samuel","family":"Pierre","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandra","family":"Apollon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emelyne","family":"Dumond","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guyrlaine Pierre Louis","family":"Forestal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vanessa","family":"Rouzier","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrice","family":"Joseph","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pierre-Yves","family":"Cremieux","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2948-2774","authenticated-orcid":false,"given":"Jean W","family":"Pape","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7464-275X","authenticated-orcid":false,"given":"Serena P","family":"Koenig","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"54368","reference":[{"key":"2024062302301029000_2024.06.19.24309189v1.1","unstructured":"World Health Organization Guidelines Review Committee. Guidelines for managing advanced HIV disease and rapid initiation of antiretroviral therapy. Geneva, Switzerland: World Health Organization;2017."},{"key":"2024062302301029000_2024.06.19.24309189v1.2","unstructured":"World Health Organization . Consolidated guidelines on HIV prevention, testing, treatment, service delivery and monitoring: recommendations for a public health approach. Geneva, Switzerland: World Health Organization;2021."},{"key":"2024062302301029000_2024.06.19.24309189v1.3","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.1818"},{"issue":"9","key":"2024062302301029000_2024.06.19.24309189v1.4","doi-asserted-by":"crossref","first-page":"e1002912","DOI":"10.1371\/journal.pmed.1002912","article-title":"Simplified clinical algorithm for identifying patients eligible for same-day HIV treatment initiation (SLATE): Results from an individually randomized trial in South Africa and Kenya","volume":"16","year":"2019","journal-title":"PLOS Medicine"},{"issue":"11","key":"2024062302301029000_2024.06.19.24309189v1.5","doi-asserted-by":"crossref","first-page":"e539","DOI":"10.1016\/S2352-3018(16)30090-X","article-title":"Effects of a multicomponent intervention to streamline initiation of antiretroviral therapy in Africa: a stepped-wedge cluster-randomised trial","volume":"3","year":"2016","journal-title":"The Lancet HIV"},{"key":"2024062302301029000_2024.06.19.24309189v1.6","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000001456"},{"issue":"7","key":"2024062302301029000_2024.06.19.24309189v1.7","doi-asserted-by":"crossref","first-page":"e1002357","DOI":"10.1371\/journal.pmed.1002357","article-title":"Same-day HIV testing with initiation of antiretroviral therapy versus standard care for persons living with HIV: A randomized unblinded trial","volume":"14","year":"2017","journal-title":"PLoS Med"},{"key":"2024062302301029000_2024.06.19.24309189v1.8","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1002015"},{"issue":"8","key":"2024062302301029000_2024.06.19.24309189v1.9","doi-asserted-by":"crossref","first-page":"e1003226","DOI":"10.1371\/journal.pmed.1003226","article-title":"A clinical algorithm for same-day HIV treatment initiation in settings with high TB symptom prevalence in South Africa: The SLATE II individually randomized clinical trial","volume":"17","year":"2020","journal-title":"PLOS Medicine"},{"issue":"8","key":"2024062302301029000_2024.06.19.24309189v1.10","doi-asserted-by":"crossref","first-page":"1176","DOI":"10.1093\/cid\/ciad317","article-title":"Treatment Outcomes After Offering Same-Day Initiation of Human Immunodeficiency Virus Treatment\u2014How to Interpret Discrepancies Between Different Studies","volume":"77","year":"2023","journal-title":"Clinical Infectious Diseases"},{"key":"2024062302301029000_2024.06.19.24309189v1.11","doi-asserted-by":"publisher","DOI":"10.1111\/hiv.13169"},{"key":"2024062302301029000_2024.06.19.24309189v1.12","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1004246"},{"key":"2024062302301029000_2024.06.19.24309189v1.13","unstructured":"Global Tuberculosis Program, World Health Organization, Country Profile. Haiti. https:\/\/worldhealthorg.shinyapps.io\/tb_profiles\/?_inputs_&entity_type=%22country%22&iso2=%22HT%22&lan=%22EN%22. Published 2024. Accessed May 10, 2024."},{"key":"2024062302301029000_2024.06.19.24309189v1.14","unstructured":"UNAIDS Country Fact Sheets. Haiti 2022. https:\/\/www.unaids.org\/en\/regionscountries\/countries\/haiti. Accessed May 10, 2024."},{"key":"2024062302301029000_2024.06.19.24309189v1.15","unstructured":"World Health Organization Operation Handbook on Tuberculosis, Module 4: Treatment \u2014 Drug- Susceptible Tuberculosis Treatment. https:\/\/www.who.int\/publications\/i\/item\/9789240050761. Published 2022. Accessed May 13, 2024."},{"issue":"20","key":"2024062302301029000_2024.06.19.24309189v1.16","doi-asserted-by":"crossref","first-page":"1915","DOI":"10.1056\/NEJMoa1800762","article-title":"Prednisone for the Prevention of Paradoxical Tuberculosis-Associated IRIS","volume":"379","year":"2018","journal-title":"New England Journal of Medicine"},{"key":"2024062302301029000_2024.06.19.24309189v1.17","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1615822"},{"key":"2024062302301029000_2024.06.19.24309189v1.18","unstructured":"Division of AIDS (DAIDS) Table for Grading the Severity of Adult and Pediatric Adverse Events. Corrected Version 2.1. July 2017. Accessed on Apirl 12, 2024 at: https:\/\/rsc.niaid.nih.gov\/sites\/default\/files\/daidsgradingcorrectedv21.pdf."},{"key":"2024062302301029000_2024.06.19.24309189v1.19","unstructured":"Hern\u00e1n M , Robins J . Chapter 12: IP Weighting and Marginal Structural Models. In: Causal Inference: What If. Boca Raton: Chapman & Hall\/CTC; 2020."},{"issue":"1","key":"2024062302301029000_2024.06.19.24309189v1.20","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1093\/biostatistics\/5.1.31","article-title":"Estimating treatment effects in studies of perinatal transmission of HIV","volume":"5","year":"2004","journal-title":"Biostatistics"},{"key":"2024062302301029000_2024.06.19.24309189v1.21","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-016-1644-y"},{"issue":"5","key":"2024062302301029000_2024.06.19.24309189v1.22","doi-asserted-by":"crossref","first-page":"e266","DOI":"10.1016\/S2352-3018(20)30358-1","article-title":"Estimated life expectancy gains with antiretroviral therapy among adults with HIV in Latin America and the Caribbean: a multisite retrospective cohort study","volume":"8","year":"2021","journal-title":"The Lancet HIV"},{"key":"2024062302301029000_2024.06.19.24309189v1.23","doi-asserted-by":"crossref","unstructured":"Richterman A , Klaiman T , Palma D , et al. B-OK: A Visual and Tactile Tool for HIV Treatment Adherence Support in a United States Urban Center. medRxiv. 2024:2024.2002.2028.24303498.","DOI":"10.1101\/2024.02.28.24303498"},{"key":"2024062302301029000_2024.06.19.24309189v1.24","doi-asserted-by":"crossref","unstructured":"Govathson C , Ndlovu N , Rambally-Greener L , et al. Increasing HIV treatment literacy among people living with HIV using a novel health communication aid: Evidence from KwaZulu Natal province, South Africa. In: Cold Spring Harbor Laboratory; 2023.","DOI":"10.1101\/2023.06.15.23291430"},{"key":"2024062302301029000_2024.06.19.24309189v1.25","doi-asserted-by":"publisher","DOI":"10.1080\/07399332.2017.1337774"},{"issue":"8","key":"2024062302301029000_2024.06.19.24309189v1.26","doi-asserted-by":"crossref","first-page":"1510","DOI":"10.1007\/s10461-014-0873-1","article-title":"Does Food Insecurity Undermine Adherence to Antiretroviral Therapy? A Systematic Review","volume":"19","year":"2015","journal-title":"AIDS Behav"},{"key":"2024062302301029000_2024.06.19.24309189v1.27","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-016-1605-5"},{"key":"2024062302301029000_2024.06.19.24309189v1.28","doi-asserted-by":"publisher","DOI":"10.1080\/09540121.2016.1191613"},{"issue":"8","key":"2024062302301029000_2024.06.19.24309189v1.29","doi-asserted-by":"crossref","first-page":"ofaa328","DOI":"10.1093\/ofid\/ofaa328","article-title":"Mortality Over Long-term Follow-up for People With HIV Receiving Longitudinal Care and Antiretroviral Therapy in Rural Haiti","volume":"7","year":"2020","journal-title":"Open Forum Infect Dis"},{"issue":"1","key":"2024062302301029000_2024.06.19.24309189v1.30","doi-asserted-by":"crossref","first-page":"e31","DOI":"10.1016\/S2352-3018(16)30206-5","article-title":"Interventions to improve adherence to antiretroviral therapy: a systematic review and network meta-analysis","volume":"4","year":"2017","journal-title":"The lancet HIV"},{"key":"2024062302301029000_2024.06.19.24309189v1.31","unstructured":"Koenig S , Wu J , Pierre S . Abstract PEB0258: HIV drug resistance (HIVDR) in Haiti: Impact on future guidelines. AIDS 2020 virtual meeting; 2020."},{"issue":"7","key":"2024062302301029000_2024.06.19.24309189v1.32","doi-asserted-by":"crossref","first-page":"e0200505","DOI":"10.1371\/journal.pone.0200505","article-title":"Baseline predictors of antiretroviral treatment failure and lost to follow up in a multicenter countrywide HIV-1 cohort study in Ethiopia","volume":"13","year":"2018","journal-title":"PloS one"},{"key":"2024062302301029000_2024.06.19.24309189v1.33","doi-asserted-by":"crossref","unstructured":"Demsie DG , Bantie AT , Allene MD , Alema NM , Gebrie D . Antiretroviral treatment failure among HIV-positive adults taking first-line therapy and associated risk factors at Adigrat General hospital, Adigart, Ethiopia 2019: A cross sectional study. International Journal of Surgery Open. 2020;26.","DOI":"10.1016\/j.ijso.2020.08.001"},{"key":"2024062302301029000_2024.06.19.24309189v1.34","doi-asserted-by":"crossref","unstructured":"Von Braun A , Sekaggya-Wiltshire C , Scherrer AU , et al. Early virological failure and HIV drug resistance in Ugandan adults co-infected with tuberculosis. AIDS Research and Therapy. 2017;14(1).","DOI":"10.1186\/s12981-016-0128-5"},{"key":"2024062302301029000_2024.06.19.24309189v1.35","doi-asserted-by":"crossref","unstructured":"Bezabih YM , Beyene F , Bezabhe WM . Factors associated with first-line antiretroviral treatment failure in adult HIV-positive patients: a case-control study from Ethiopia. BMC infectious diseases. 2019;19(1).","DOI":"10.1186\/s12879-019-4170-5"},{"key":"2024062302301029000_2024.06.19.24309189v1.36","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0028691"},{"key":"2024062302301029000_2024.06.19.24309189v1.37","unstructured":"Raynell Lang , Sally B. Coburn , M. John Gill , et al. Abstract 688: Association of Anemia on Survival among People with HIV after ART Initiation. Conference on Retrovirology and Opportunistic Infections (CROI) 2023; 2023; Seattle, Washington."}],"container-title":[],"original-title":[],"link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1101\/2024.06.19.24309189","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T20:03:49Z","timestamp":1768507429000},"score":1,"resource":{"primary":{"URL":"http:\/\/medrxiv.org\/lookup\/doi\/10.1101\/2024.06.19.24309189"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,20]]},"references-count":37,"URL":"https:\/\/doi.org\/10.1101\/2024.06.19.24309189","relation":{"is-preprint-of":[{"id-type":"doi","id":"10.1093\/ofid\/ofaf031","asserted-by":"subject"}]},"subject":[],"published":{"date-parts":[[2024,6,20]]},"subtype":"preprint"}}