Comparable clinical outcomes with same-day versus rapid initiation of antiretroviral therapy in Taiwan.

Autor:	Huang YC; Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan., Yang CJ; Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan., Sun HY; Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan., Lee CH; Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung, Taiwan; Department of Internal Medicine, Chiayi Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung, Taiwan., Lu PL; Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; School of Post-Baccalaureate Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan., Tang HJ; Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan., Liu CE; Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan., Lee YT; Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan; School of Medicine, Chung Shan Medical University, Taichung, Taiwan., Tsai CS; Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan., Lee NY; Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan., Liou BH; Department of Internal Medicine, Hsinchu Mackay Memorial Hospital, Hsin-Chu, Taiwan., Hung TC; Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan., Lee MH; Department of Internal Medicine, Shuang-Ho Hospital, Taipei Medical University, New Taipei City, Taiwan., Huang MH; Department of Internal Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan., Wang NC; Department of Internal Medicine, Tri-Service General Hospital, Taipei, Taiwan., Lin CY; Department of Internal Medicine, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan., Lee YC; Department of Internal Medicine, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei, Taiwan; School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei, Taiwan., Cheng SH; School of Public Health, Taipei Medical University, Taipei, Taiwan; Department of Infectious Diseases, Taoyuan General Hospital, Taoyuan, Taiwan., Hung CC; Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan; Department of Tropical Medicine and Parasitology, National Taiwan University College of Medicine, Taipei, Taiwan. Electronic address: hcc0401@ntu.edu.tw.
Jazyk:	angličtina
Zdroj:	International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases [Int J Infect Dis] 2024 Mar; Vol. 140, pp. 1-8. Date of Electronic Publication: 2023 Dec 30.
DOI:	10.1016/j.ijid.2023.12.012
Abstrakt:	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. (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze:	MEDLINE
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