Time between diagnosis and achievement of virologic suppression in people living with HIV
| Autor: | Joan Duggan, Lindsey Eitniear, Kelli Cole, Eric G. Sahloff, Danica Joy C Ilagan |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Pharmacology
Pediatrics medicine.medical_specialty business.industry Health Policy Public health Human immunodeficiency virus (HIV) Retrospective cohort study Delayed treatment 030204 cardiovascular system & hematology medicine.disease_cause Antiretroviral therapy Additional research Treatment and control groups 03 medical and health sciences 0302 clinical medicine Interquartile range medicine 030212 general & internal medicine business |
| Zdroj: | American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists. |
| ISSN: | 1535-2900 |
| Popis: | Purpose Data support the individual and public health advantages of shortened time intervals between HIV diagnosis, initiation of antiretroviral therapy (ART), and virologic suppression. The time from HIV diagnosis to linkage to care, initiation of ART, and virologic suppression was evaluated in newly diagnosed, ART-naive individuals after structured programmatic changes were implemented to reduce time to virologic suppression (TVS). Methods The retrospective cohort included newly diagnosed, ART-naive adult patients receiving care in a Midwestern Ryan White Clinic. Study periods were between January 1, 2015, and December 31, 2015 (delayed treatment group) and January 1, 2017, and December 31, 2017 (rapid treatment group). Changes during the intervention time period were related to access to care and ART. The primary outcome of time from HIV diagnosis to virologic suppression was compared between the groups. Secondary outcomes included the time from diagnosis to linkage to care and the time to initiation of ART. Results Twenty-four and 35 individuals were included in the control and intervention groups, respectively. Median (interquartile range) time from diagnosis to viral suppression was 137 (77-318) days in the delayed treatment group vs 76.5 (51-151) days in the rapid treatment group (P = 0.021). Time from diagnosis to first clinic visit remained similar (median of 13.5 vs 15 days, P = 0.859), while time from first clinic visit to initiation of ART decreased significantly (median of 15 vs 0 days, P < 0.001). Conclusion Time from first clinic visit to ART initiation was significantly shortened in this intervention and was the driving force to decreasing TVS. Additional research into barriers impacting time from diagnosis to linkage to care are needed to further shorten TVS. |
| Databáze: | OpenAIRE |
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