HIV | Reality

”Treatment is not yet necessary”: delays in seeking access to HIV treatment in Uganda and Zimbabwe


Authors: Kawuma R, Seeley J, Mupambireyi Z, Cowan F, Bernays S; for REALITY Trial Team

Published in: Afr J AIDS Res. 2018;17(3):217-225

Abstract We examined the logic that individuals use to account for delaying HIV testing and/or initiating HIV treatment. Our qualitative study, situated within the REALITY trial (Reduction of EArly mortaLITY in HIV infected adults and children starting antiretroviral therapy),

Effect of ready-to-use supplementary food on mortality in severely immunocompromised HIV-infected individuals in Africa initiating antiretroviral therapy (REALITY): an open-label, parallel-group, randomised controlled trial


Authors: Mallewa J, Szubert AJ, Mugyenyi P, et al.

Published in: Lancet HIV. 2018;5(5):e231-e240

Background In sub-Saharan Africa, severely immunocompromised HIV-infected individuals have a high risk of mortality during the first few months after starting antiretroviral therapy (ART). We hypothesise that universally providing ready-to-use supplementary food (RUSF) would increase early weight gain, thereby reducing early mortality compared with current guidelines recommending ready-to-use therapeutic food (RUTF) for severely malnourished individuals only.

Raltegravir-intensified initial antiretroviral therapy in advanced HIV disease in Africa: a randomised controlled trial


Authors: Kityo C, Szubert AJ, Siika A, et al.

Published in: PLoS Med. 2018; 15(12):e1002706

Background In sub-Saharan Africa, individuals infected with HIV who are severely immunocompromised have high mortality (about 10%) shortly after starting antiretroviral therapy (ART). This group also has the greatest risk of morbidity and mortality associated with immune reconstitution inflammatory syndrome (IRIS),

Causes and timing of mortality and morbidity among late presenters starting antiretroviral therapy in the REALITY trial


Authors: Post FA, Szubert AJ, Prendergast AJ, et al; for Reduction of early mortality in HIV-infected adults and children starting an antiretroviral therapy (REALITY) trial team

Published in: Clin Infect Dis. 2018;66(2):S132-S139

Background In sub-Saharan Africa, 20%-25% of people starting antiretroviral therapy (ART) have severe immunosuppression; approximately 10% die within 3 months. In the Reduction of EArly mortaLITY (REALITY) randomized trial,

Late presentation with HIV in Africa: phenotypes, risk, and risk stratification in the REALITY Trial


Authors: Siika A, McCabe L, Bwakura-Dangarembizi M, et al; for REALITY Trial Team

Published in: Clin Infect Dis. 2018;66(2):S140-S146

Background Severely immunocompromised human immunodeficiency virus (HIV)–infected individuals have high mortality shortly after starting antiretroviral therapy (ART). We investigated predictors of early mortality and “late presenter” phenotypes.

Methods The Reduction of EArly MortaLITY (REALITY) trial enrolled ART-naive adults and children ≥5 years of age with CD4 counts <100 cells/μL initiating ART in Uganda,

Enhanced prophylaxis plus antiretroviral therapy for advanced HIV infection in Africa


Authors: Hakim J, Musiime V, Szubert AJ; REALITY Trial Team

Published in: N Engl J Med. 2017;377(3):233-245

Background In sub-Saharan Africa, among patients with advanced human immunodeficiency virus (HIV) infection, the rate of death from infection (including tuberculosis and cryptococcus) shortly after the initiation of antiretroviral therapy (ART) is approximately 10%.

Methods In this factorial open-label trial conducted in Uganda,