Reasons for delayed antiretroviral therapy (ART) initiation in the era of early ART initiation guidelines: a retrospective service evaluation
Autor: | Julie Fox, Esra Musbahi, Katia Eh Florman, Ming J. Lee, Angela C Bailey, Serena Venturelli, Jhia Jiat Teh, Ojali Negedu, Sarah Fidler, Nicola Mackie, Wayne McKenna |
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Rok vydání: | 2019 |
Předmět: |
Adult
Male medicine.medical_specialty Anti-HIV Agents Art initiation Time to treatment Medication adherence HIV Infections Dermatology Medication Adherence Time-to-Treatment 03 medical and health sciences 0302 clinical medicine ANTIRETROVIRAL AGENTS Antiretroviral Therapy Highly Active medicine Humans Pharmacology (medical) 030212 general & internal medicine Intensive care medicine Retrospective Studies Service (business) 030505 public health business.industry Public Health Environmental and Occupational Health Middle Aged Viral Load Antiretroviral therapy CD4 Lymphocyte Count Infectious Diseases Female 0305 other medical science business |
Zdroj: | International Journal of STD & AIDS. 30:415-418 |
ISSN: | 1758-1052 0956-4624 |
Popis: | Following changes in national antiretroviral therapy (ART) guidelines removing the CD4 threshold for initiation of ART, we evaluated the time to ART initiation and reasons for delayed or non-initiation. A retrospective notes review of 292 newly diagnosed HIV-positive individuals attending two London clinics between August 2015 and December 2016 was performed. Two hundred and fifty-four of 292 (87%) individuals started ART. Median time to ART initiation was 29 days (range: 0–514). Thirty of 292 (13%) did not start ART. Rates of virological suppression at six months were similar regardless of time to ART initiation. People who inject drugs (16.7% vs. 3.6%) (p = 0.009), having a higher median baseline CD4 cell count (500 vs. 388 cells/mm3, p = 0.001), and having gastrointestinal/liver co-morbidities (23% vs. 9%, p = 0.001) were associated with delayed ART initiation. The cohort not on ART had a higher median baseline CD4 cell count (500 vs. 388 cells/mm3, p |
Databáze: | OpenAIRE |
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