Cochrane · systematic review · CD009012

Early versus delayed antiretroviral treatment in HIV‐positive people with cryptococcal meningitis

Eshun‐Wilson, I, Okwen, MP, Richardson, M, et al. · Cochrane Database of Systematic Reviews · 2018 · Cochrane Library

Infectious Diseases2 versionsAMSTAR 2: not assessed

SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.

Questions

current version

GRADE rated

No studies

Included studies

No studies 0 · 0%Ungraded 0 · 0%Very low 2 · 50%Low 2 · 50%Moderate 0 · 0%High 0 · 0%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

Questions and results

Current version only

Early ART compared to delayed ART initiation in HIV‐positive people with cryptococcal meningitis

Population: HIV‐positive people with cryptococcal meningitis

CD009012.PUB3 (current) · 4 questions

Outcome	Effect	Evidence	Status / GRADE
All‐cause mortality at 6 to 12 months Early ART vs delayed ART initiation	RR 1.42 [1.02, 1.97]	4 studies · 294 participants	Low Downgraded: risk of bias, imprecision, inconsistency
Cryptococcal meningitis relapse Early ART vs delayed ART initiation	RR 0.27 [0.07, 1.04]	2 studies · 205 participants	Low Downgraded: imprecision
Cryptococcal IRIS Early ART vs delayed ART initiation	RR 3.56 [0.51, 25.02]	2 studies · 205 participants	Very low Downgraded: risk of bias, imprecision, indirectness
HIV virological suppression at 6 months (viral load < 400 copies/mL) Early ART vs delayed ART initiation	RR 0.93 [0.72, 1.22]	2 studies · 205 participants	Very low Downgraded: risk of bias, imprecision

Early ART initiation versus delayed ART initiation

Population: patients with antiretroviral therapy initiation in patients with HIV infection and concurrent cryptococcal meningitis

CD009012.PUB2 · 2 questions

Outcome	Effect	Evidence	Status / GRADE
Death Early ART initiation vs delayed ART initiation	RR 1.4 [0.42, 4.68]	2 studies · 89 participants	Low
AIDS progression Early ART initiation vs delayed ART initiation	RR 1.63 [0.84, 3.16]	2 studies · 89 participants	Very low