Journal Article > ResearchFull Text
Lancet. 2001 December 8; Volume 358 (Issue 9297); DOI:10.1016/S0140-6736(01)06995-1
Shafer J, Falzon D, Small I, Kittle D, Ford NP
Lancet. 2001 December 8; Volume 358 (Issue 9297); DOI:10.1016/S0140-6736(01)06995-1
Journal Article > CommentaryFull Text
PLOS Med. 2020 February 14; Volume 17 (Issue 2); e1003028.; DOI:10.1371/journal.pmed.1003028.
Ford NP, Geng EH, Ellman T, Orrell C, Ehrenkranz PD, et al.
PLOS Med. 2020 February 14; Volume 17 (Issue 2); e1003028.; DOI:10.1371/journal.pmed.1003028.
Journal Article > Meta-AnalysisFull Text
PLOS One. 2013 July 22; Volume 8 (Issue 7); e68995.; DOI:10.1371/journal.pone.0068995
Pillay P, Ford NP, Shubber Z, Ferrand RA
PLOS One. 2013 July 22; Volume 8 (Issue 7); e68995.; DOI:10.1371/journal.pone.0068995
INTRODUCTION
There is conflicting evidence and practice regarding the use of the non-nucleoside reverse transcriptase inhibitors (NNRTI) efavirenz (EFV) and nevirapine (NVP) in first-line antiretroviral therapy (ART).
METHODS
We systematically reviewed virological outcomes in HIV-1 infected, treatment-naive patients on regimens containing EFV versus NVP from randomised trials and observational cohort studies. Data sources include PubMed, Embase, the Cochrane Central Register of Controlled Trials and conference proceedings of the International AIDS Society, Conference on Retroviruses and Opportunistic Infections, between 1996 to May 2013. Relative risks (RR) and 95% confidence intervals were synthesized using random-effects meta-analysis. Heterogeneity was assessed using the I(2) statistic, and subgroup analyses performed to assess the potential influence of study design, duration of follow up, location, and tuberculosis treatment. Sensitivity analyses explored the potential influence of different dosages of NVP and different viral load thresholds.
RESULTS
Of 5011 citations retrieved, 38 reports of studies comprising 114 391 patients were included for review. EFV was significantly less likely than NVP to lead to virologic failure in both trials (RR 0.85 [0.73-0.99] I(2) = 0%) and observational studies (RR 0.65 [0.59-0.71] I(2) = 54%). EFV was more likely to achieve virologic success than NVP, though marginally significant, in both randomised controlled trials (RR 1.04 [1.00-1.08] I(2) = 0%) and observational studies (RR 1.06 [1.00-1.12] I(2) = 68%).
CONCLUSION
EFV-based first line ART is significantly less likely to lead to virologic failure compared to NVP-based ART. This finding supports the use of EFV as the preferred NNRTI in first-line treatment regimen for HIV treatment, particularly in resource limited settings.
There is conflicting evidence and practice regarding the use of the non-nucleoside reverse transcriptase inhibitors (NNRTI) efavirenz (EFV) and nevirapine (NVP) in first-line antiretroviral therapy (ART).
METHODS
We systematically reviewed virological outcomes in HIV-1 infected, treatment-naive patients on regimens containing EFV versus NVP from randomised trials and observational cohort studies. Data sources include PubMed, Embase, the Cochrane Central Register of Controlled Trials and conference proceedings of the International AIDS Society, Conference on Retroviruses and Opportunistic Infections, between 1996 to May 2013. Relative risks (RR) and 95% confidence intervals were synthesized using random-effects meta-analysis. Heterogeneity was assessed using the I(2) statistic, and subgroup analyses performed to assess the potential influence of study design, duration of follow up, location, and tuberculosis treatment. Sensitivity analyses explored the potential influence of different dosages of NVP and different viral load thresholds.
RESULTS
Of 5011 citations retrieved, 38 reports of studies comprising 114 391 patients were included for review. EFV was significantly less likely than NVP to lead to virologic failure in both trials (RR 0.85 [0.73-0.99] I(2) = 0%) and observational studies (RR 0.65 [0.59-0.71] I(2) = 54%). EFV was more likely to achieve virologic success than NVP, though marginally significant, in both randomised controlled trials (RR 1.04 [1.00-1.08] I(2) = 0%) and observational studies (RR 1.06 [1.00-1.12] I(2) = 68%).
CONCLUSION
EFV-based first line ART is significantly less likely to lead to virologic failure compared to NVP-based ART. This finding supports the use of EFV as the preferred NNRTI in first-line treatment regimen for HIV treatment, particularly in resource limited settings.
Journal Article > CommentaryFull Text
PLoS Negl Trop Dis. 2015 November 12; Volume 9 (Issue 11); e0004075.; DOI:10.1371/journal.pntd.0004075
O'Brien DP, Ford NP, Vitoria M, Asiedu K, Calmy A, et al.
PLoS Negl Trop Dis. 2015 November 12; Volume 9 (Issue 11); e0004075.; DOI:10.1371/journal.pntd.0004075
Journal Article > ReviewFull Text
Lancet Global Health. 2021 May 1; Volume 9 (Issue 5); e681-e690.; DOI:10.1016/S2214-109X(20)30539-8
Park JS, Grais RF, Taljaard M, Nakimuli-Mpungu E, Jehan F, et al.
Lancet Global Health. 2021 May 1; Volume 9 (Issue 5); e681-e690.; DOI:10.1016/S2214-109X(20)30539-8
This paper shows the scale of global health research and the context in which we frame the subsequent papers in the Series. In this Series paper, we provide a historical perspective on clinical trial research by revisiting the 1948 streptomycin trial for pulmonary tuberculosis, which was the first documented randomised clinical trial in the English language, and we discuss its close connection with global health. We describe the current state of clinical trial research globally by providing an overview of clinical trials that have been registered in the WHO International Clinical Trial Registry since 2010. We discuss challenges with current trial planning and designs that are often used in clinical trial research undertaken in low-income and middle-income countries, as an overview of the global health trials landscape. Finally, we discuss the importance of collaborative work in global health research towards generating sustainable and culturally appropriate research environments.
Journal Article > ResearchFull Text
PLOS Med. 2005 February 1; Volume 2 (Issue 2); DOI:10.1371/journal.pmed.0020014
Dentico N, Ford NP
PLOS Med. 2005 February 1; Volume 2 (Issue 2); DOI:10.1371/journal.pmed.0020014
Journal Article > CommentaryAbstract
Int J Drug Policy. 2015 May 18; Volume 26 (Issue 11); DOI:10.1016/j.drugpo.2015.05.004
Ford NP, Wiktor SZ, Kaplan K, Andrieux-Meyer I, Hill AM, et al.
Int J Drug Policy. 2015 May 18; Volume 26 (Issue 11); DOI:10.1016/j.drugpo.2015.05.004
Journal Article > LetterFull Text
Lancet. 2002 April 13; Volume 359 (Issue 9314); 1351.; DOI:10.1016/S0140-6736(02)08303-4
Ford NP, 't Hoen E
Lancet. 2002 April 13; Volume 359 (Issue 9314); 1351.; DOI:10.1016/S0140-6736(02)08303-4
Journal Article > ResearchFull Text
Disasters. 2003 June 1; Volume 27 (Issue 2); 141-153.; DOI:10.1111/1467-7717.00225
Van Herp M, Parqué V, Rackley E, Ford NP
Disasters. 2003 June 1; Volume 27 (Issue 2); 141-153.; DOI:10.1111/1467-7717.00225
The people of the Democratic Republic of Congo for decades have been living in a situation of chronic crisis. Violence, population displacement and the destruction of infrastructure and health services have devastated the health of the population. In 2001, Médicins Sans Frontières conducted a survey in five areas of western and central DRC to assess mortality, access to health-care, vaccination coverage and exposure to violence. High mortality rates were found in front-line zones, mainly due to malnutrition and infectious diseases. In Basankusu approximately 10 per cent of the total population and 25 per cent of the under-five population had perished in the year before the survey. Humanitarian needs remain acute across the country, particularly near the front line. Infectious-disease control and treatment are a priority, as is increasing access to health-care. Humanitarian assistance must be increased considerably, especially in rural areas and zones that have been affected directly by conflict.
Journal Article > CommentaryFull Text
Lancet. 2000 June 10; Volume 355 (Issue 9220); 2067-2068.; DOI:10.1016/S0140-6736(00)02364-3
de Jong J, Mulhern M, Ford NP, van der Kam S, Kleber RJ
Lancet. 2000 June 10; Volume 355 (Issue 9220); 2067-2068.; DOI:10.1016/S0140-6736(00)02364-3