Comparable clinical outcomes with same-day versus rapid initiation of antiretroviral therapy in Taiwan
Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved..
OBJECTIVES: WHO has recommended same-day antiretroviral therapy (SDART) initiation since 2017; however, higher attrition rates were noted in developing countries.
METHODS: We included newly diagnosed people with HIV (PWH) from 2018 to 2022 at 18 hospitals around Taiwan. SDART initiation was defined as starting ART on the same day of HIV diagnosis and rapid initiation as starting ART within 14 days of diagnosis. A composite unfavorable outcome was defined as death after 30 days of diagnosis, loss to follow-up (LTFU), or virologic failure or rebound at 12 months.
RESULTS: At 12 months, PWH on SDART initiation and those on rapid ART initiation showed similar rates of engagement in care with plasma HIV-1 RNA <50 copies/mL (87.5% vs 87.7%) and composite unfavorable outcome (7.7% vs 7.7%). PWH aged >30 years were less likely to have LTFU (aHR 0.44, 95% CI 0.28-0.70). PWH aged >30 years (aHR 0.59, 95% CI 0.41-0.85) and gay, bisexual, and men who have sex with men (GBMSM) (aHR 0.50, 95% CI 0.32-0.79) were less likely to have composite unfavorable outcomes.
CONCLUSIONS: SDART and rapid ART initiation resulted in comparable clinical outcomes and viral suppression rates. PWH aged >30 years and GBMSM were less likely to have unfavorable outcomes.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:140 |
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| Enthalten in: |
International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases - 140(2024) vom: 30. Feb., Seite 1-8 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Huang, Yi-Chia [VerfasserIn] |
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| Links: |
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| Themen: |
Anti-HIV Agents |
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| Anmerkungen: |
Date Completed 23.02.2024 Date Revised 23.02.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.ijid.2023.12.012 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 500 | |a published: Print-Electronic | ||
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| 520 | |a Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved. | ||
| 520 | |a OBJECTIVES: WHO has recommended same-day antiretroviral therapy (SDART) initiation since 2017; however, higher attrition rates were noted in developing countries | ||
| 520 | |a METHODS: We included newly diagnosed people with HIV (PWH) from 2018 to 2022 at 18 hospitals around Taiwan. SDART initiation was defined as starting ART on the same day of HIV diagnosis and rapid initiation as starting ART within 14 days of diagnosis. A composite unfavorable outcome was defined as death after 30 days of diagnosis, loss to follow-up (LTFU), or virologic failure or rebound at 12 months | ||
| 520 | |a RESULTS: At 12 months, PWH on SDART initiation and those on rapid ART initiation showed similar rates of engagement in care with plasma HIV-1 RNA <50 copies/mL (87.5% vs 87.7%) and composite unfavorable outcome (7.7% vs 7.7%). PWH aged >30 years were less likely to have LTFU (aHR 0.44, 95% CI 0.28-0.70). PWH aged >30 years (aHR 0.59, 95% CI 0.41-0.85) and gay, bisexual, and men who have sex with men (GBMSM) (aHR 0.50, 95% CI 0.32-0.79) were less likely to have composite unfavorable outcomes | ||
| 520 | |a CONCLUSIONS: SDART and rapid ART initiation resulted in comparable clinical outcomes and viral suppression rates. PWH aged >30 years and GBMSM were less likely to have unfavorable outcomes | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Care continuum | |
| 650 | 4 | |a Engagement in care | |
| 650 | 4 | |a Test-and-treat | |
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| 700 | 1 | |a Yang, Chia-Jui |e verfasserin |4 aut | |
| 700 | 1 | |a Sun, Hsin-Yun |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, Chen-Hsiang |e verfasserin |4 aut | |
| 700 | 1 | |a Lu, Po-Liang |e verfasserin |4 aut | |
| 700 | 1 | |a Tang, Hung-Jen |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, Chun-Eng |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, Yuan-Ti |e verfasserin |4 aut | |
| 700 | 1 | |a Tsai, Chin-Shiang |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, Nan-Yao |e verfasserin |4 aut | |
| 700 | 1 | |a Liou, Bo-Huang |e verfasserin |4 aut | |
| 700 | 1 | |a Hung, Tung-Che |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, Mei-Hui |e verfasserin |4 aut | |
| 700 | 1 | |a Huang, Miao-Hui |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Ning-Chi |e verfasserin |4 aut | |
| 700 | 1 | |a Lin, Chi-Ying |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, Yi-Chien |e verfasserin |4 aut | |
| 700 | 1 | |a Cheng, Shu-Hsing |e verfasserin |4 aut | |
| 700 | 1 | |a Hung, Chien-Ching |e verfasserin |4 aut | |
| 700 | 0 | |a Taiwan HIV Study Group |e verfasserin |4 aut | |
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