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

Abstract

PurposeThe 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.ParticipantsIeDEA 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 dateThe 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 plansIeDEA 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.

Mental health, substance use and viral suppression in adolescents receiving ART at a paediatric HIV clinic in South Africa

“…We followed a cohort of HIV-positive adolescents who enrolled in HIV care at the Rahima Moosa Mother and Child Hospital in Johannesburg, South Africa. The clinic participates in the International epidemiology Databases to Evaluate AIDS in Southern Africa (IeDEA-SA) and regularly transfers de-> identified routine clinical data of HIV-positive mothers, children and adolescents to the IeDEA-SA data centres at the University of Cape Town and the University of Bern [43].…”

Excess mortality associated with mental illness in people living with HIV in Cape Town, South Africa: a cohort study using linked electronic health records

“…ART programme data covering the period from Jan 1, 2004, to Dec 31, 2017, were provided by the International Epidemiology Database to Evaluate AIDS (IeDEA) Southern Africa collaboration. 11 Mental health records covering the period from Jan 1, 2010 (the start of electronic collection of records), to Dec 31, 2017, were provided by the Western Cape Provincial Health Data Centre. 12 This service links patient information from several routine health information systems, including hospital discharge summaries (with International Classification of Diseases, 10th Revision [ICD-10] diagnoses) and pharmacy records, via a unique identifier.…”

Substance use service availability in HIV treatment programs: Data from the global IeDEA consortium, 2014-2015 and 2017

“…IeDEA is funded by the U.S. National Institutes of Health to collect globally diverse clinical observational HIV treatment data from PLWH. HIV care and treatment sites participating in IeDEA are primarily public-sector health facilities and are comprised of both academic and community-based hospitals and health centers [39,40]. Because IeDEA sites have the capacity to routinely contribute electronic data, these sites may function at a higher level than HIV treatment sites not participating in IeDEA.…”

“…The IeDEA consortium is a global research consortium established in 2006 of HIV treatment sites in seven geographic regions: Central Africa; East Africa; South Africa; West Africa; the Asia-Pacific; the Caribbean, Central, and South America (CCASAnet); and North America (NA-ACCORD) [ 36 – 39 ]. IeDEA is funded by the U.S. National Institutes of Health to collect globally diverse clinical observational HIV treatment data from PLWH.…”