Table 2. Overall and pooled change in 6-month cumulative incidence of antiretroviral treatment initiation (CI-ART) after ART eligibility guideline expansion to CD4 ≤ 350 and CD4 ≤ 500.
| Guideline expansion to CD4 ≤ 350 | Guideline expansion to CD4 ≤ 500 | |||||||
|---|---|---|---|---|---|---|---|---|
| N sites | Median baseline 6-month CI-ART (IQR) | N patients | Estimate (95% CI) | N sites | Median baseline 6-month CI-ART (IQR) | N patients | Estimate (95% CI) | |
| Overall | 145 | 53 (46–59) | 169,717 | 4.3 (2.6–6.1) | 152 | 57 (50–64) | 128,552 | 15.9 (14.3–17.4) |
| Patient level (medians and estimates of change in 6-month CI-ART are restricted to patient strata) | ||||||||
| Sexa | ||||||||
| Men | 129 | 56 (48–64) | 66,656 | 4.1 (2.2–5.9) | 117 | 61 (52–68) | 50,116 | 13.7 (12.0–15.4) |
| Women | 127 | 54 (45–58) | 101,284 | 4.6 (2.6–6.5) | 131 | 58 (50–64) | 74,154 | 16.8 (15.0–18.6) |
| Age at enrollmenta | ||||||||
| 16–24 years | 90 | 45 (35–51) | 28,150 | 4.4 (2.0–6.8) | 82 | 51 (45–58) | 22,210 | 21.5 (18.9–24.2) |
| ≥25 years | 143 | 55 (48–62) | 139,228 | 4.4 (2.6–6.1) | 148 | 60 (50–67) | 102,974 | 15.5 (13.8–17.3) |
| CD4 count at enrollmentb | ||||||||
| CD4 201–350 (newly eligible) | 91 | 61 (50–70) | 29,964 | 18.2 (15.3–21.1) | ||||
| CD4 ≤ 200 (previously eligible) | 91 | 84 (80–88) | 49,615 | −0.6 (−2.0–0.7) | ||||
| CD4 351–500 (newly eligible) | 52 | 36 (27–45) | 10,824 | 47.4 (41.5–53.4) | ||||
| CD4 ≤ 350 (previously eligible) | 52 | 84 (78–88) | 36,199 | 4.9 (3.3–6.5) | ||||
| Site level (medians and estimates of change in 6-month CI-ART are for overall site population) | ||||||||
| Region | ||||||||
| Asia-Pacific | 6 | 74 (47–76) | 2,868 | 12.0 (-4.2–28.1) | 2 | 73 (62–83) | 378 | 13.5 (-0.5–27.4) |
| Central Africa | 12 | 37 (31–46) | 5,886 | 7.3 (-3.5–18.1) | 13 | 55 (52–61) | 3,559 | 7.4 (0.4–14.3) |
| East Africa | 36 | 53 (47–56) | 42,804 | 7.6 (4.3–10.9) | 46 | 53 (47–59) | 36,856 | 15.8 (12.9–18.6) |
| North America | 13 | 46 (40–55) | 7,262 | 4.6 (-0.2–9.4) | 10 | 50 (43–59) | 6,949 | 13.7 (9.4–18.1) |
| Southern Africa | 73 | 56 (49–62) | 109,012 | 1.7 (-0.5–3.8) | 78 | 60 (51–66) | 79,664 | 17.6 (15.2–20.0) |
| South and Central America | 5 | 54 (52–68) | 1,885 | 4.9 (-4.1–13.7) | 3 | 62 (61–71) | 1,146 | 12.1 (6.5–17.7) |
| Site setting | ||||||||
| Urban | 72 | 52 (41–58) | 81,077 | 5.3 (3.0–7.7) | 65 | 58 (52–62) | 60,410 | 14.2 (12.1–16.3) |
| Rural | 42 | 56 (50–60) | 61,200 | 4.7 (1.3–8.1) | 52 | 56 (48–66) | 45,690 | 16.7 (14.0–19.4) |
| Unknown | 31 | 52 (42–62) | 27,440 | 1.4 (-2.4–5.3) | 35 | 61 (50–65) | 22,452 | 17.7 (12.7–22.7) |
| % female (overall, in “pre” and “post” periods) | ||||||||
| ≤45% | 24 | 53 (41–63) | 12,006 | 6.5 (1.4–11.6) | 17 | 60 (46–62) | 9,142 | 14.7 (11.4–18.1) |
| >45–65% | 75 | 53 (46–60) | 109,189 | 3.8 (1.4–6.2) | 88 | 60 (49–66) | 92,559 | 17.1 (14.9–19.4) |
| >65% | 46 | 54 (45–58) | 48,522 | 4.4 (1.5–7.2) | 47 | 53 (50–59) | 26,851 | 13.8 (11.0–16.5) |
| Baseline (“pre” period) 6-month CI-ART among all patients | ||||||||
| Top quartile | 37 | 66 (62–71) | 56,226 | 0.4 (−2.2–2.9) | 38 | 69 (66–74) | 48,519 | 10.6 (8.6–12.7) |
| Middle-high quartile | 36 | 56 (54–58) | 53,729 | 3.0 (−0.1–6.0) | 38 | 61 (59–62) | 35,632 | 16.8 (14.4–19.2) |
| Middle-low quartile | 35 | 50 (47–52) | 30,726 | 3.0 (−0.2–6.1) | 38 | 53 (52–55) | 26,486 | 12.4 (9.6–15.1) |
| Bottom quartile | 37 | 37 (32–41) | 29,036 | 11.8 (7.4–16.2) | 38 | 42 (38–47) | 17,915 | 26.2 (20.7–31.7) |
| Baseline (“pre” period) 6-month CI-ART among previously ART eligible patientsc | ||||||||
| Top quartile | 32 | 57 (48–67) | 21,874 | −0.1 (−3.5–3.4) | 32 | 63 (60–69) | 23,656 | 12.9 (10.2–15.7) |
| Middle-high quartile | 32 | 56 (52–62) | 35,844 | 3.7 (−0.1–7.5) | 33 | 63 (58–68) | 38,794 | 14.4 (12.0–16.9) |
| Middle-low quartile | 32 | 55 (49–60) | 60,833 | 5.9 (2.2–9.7) | 31 | 57 (51–62) | 35,175 | 16.2 (12.8–19.7) |
| Bottom quartile | 32 | 51 (40–55) | 48,158 | 5.5 (2.8–8.2) | 33 | 47 (42–52) | 26,946 | 19.3 (13.8–24.7) |
| “post” period % ART eligible under expanded guidelinesd,e | ||||||||
| Top quartile | 36 | 55 (47–60) | 45,601 | 4.9 (2.4–7.5) | 37 | 60 (50–63) | 27,394 | 14.6 (11.2–18.0) |
| Middle-high quartile | 36 | 55 (45–58) | 53,044 | 7.9 (4.4–11.4) | 37 | 57 (49–63) | 32,586 | 16.9 (13.9–20.0) |
| Middle-low quartile | 36 | 55 (49–61) | 37,526 | 2.6 (−0.2–5.5) | 37 | 59 (52–65) | 37,936 | 16.0 (13.0–19.0) |
| Bottom quartile | 37 | 47 (39–54) | 33,546 | 1.4 (−3.2–5.9) | 37 | 55 (48–62) | 29,114 | 16.2 (11.7–20.8) |
a Includes only sites with ≥30 patients in each “pre” and “post” period in the given stratum
b Includes only sites with ≥30 patients in each “pre” and “post” period in both strata
c Includes only sites with ≥30 previously eligible patients in the “pre” period
d Includes only sites with ≥10 patients with known ART eligibility in the “post” period
e Patients with unknown eligibility included in denominator of proportions.