Objectives: To describe: (i) factors associated with rapid and delayed ART initiation; (ii) rates of 12week virological response; and (iii) virologically controlled retention in care by 1year from ART initiation according to timing of start in a real-life setting.Methods: All individuals in the Icona cohort diagnosed with HIV in 2016-17 who initiated ART were grouped according to the time between HIV diagnosis and ART initiation: Group 1, <= 7days; Group 2, 8-14days; Group 3, 15-30days; Group 4, 31-120days; and Group 5, >120days. Multivariable logistic regression models were used to identify factors associated with: (i) the probability of rapid (Group 1) and very delayed (Group 5) ART initiation; (ii) the 12week virological response (by a modified snapshot algorithm); and (iii) the probability of retention in care at 1year (on ART with HIV-RNA <50copies/mL).Results: A total of 1247 individuals were included [82 (6.6%) in Group 1, 115 (9.2%) in Group 2, 267 (21.4%) in Group 3, 641 (51.4%) in Group 4 and 142 (11.4%) in Group 5]. Main predictors of rapid ART start (Group 1) were low CD4 cell count and high HIV-RNA at first contact with the infectious diseases centre. There was no association between probability of virological response and timing of ART initiation. Overall, 90% of individuals remained on ART after 1year, 91% with undetectable HIV-RNA. Participants of Italian nationality, those with higher CD4 cell count and lower HIV-RNA at ART initiation were more likely to be retained in care after 1year.Conclusions: In our high-income observational setting, we did not observe differences in the 1year rate of virological response and retention in care according to timing of ART initiation.

Virological response and retention in care according to time of starting ART in Italy: data from the Icona Foundation Study cohort

Saracino, Annalisa;Castelli, F;Galli, M;Ippolito, G;Lo Caputo, S;Lo Caputo, S;Monno, L;Galli, L;Macchia, M;Costantini, A;Monno, L;Milano, E;Pan, A;Galli, M;Esposito, V;Capozzi, M;Montagnani, F;
2020-01-01

Abstract

Objectives: To describe: (i) factors associated with rapid and delayed ART initiation; (ii) rates of 12week virological response; and (iii) virologically controlled retention in care by 1year from ART initiation according to timing of start in a real-life setting.Methods: All individuals in the Icona cohort diagnosed with HIV in 2016-17 who initiated ART were grouped according to the time between HIV diagnosis and ART initiation: Group 1, <= 7days; Group 2, 8-14days; Group 3, 15-30days; Group 4, 31-120days; and Group 5, >120days. Multivariable logistic regression models were used to identify factors associated with: (i) the probability of rapid (Group 1) and very delayed (Group 5) ART initiation; (ii) the 12week virological response (by a modified snapshot algorithm); and (iii) the probability of retention in care at 1year (on ART with HIV-RNA <50copies/mL).Results: A total of 1247 individuals were included [82 (6.6%) in Group 1, 115 (9.2%) in Group 2, 267 (21.4%) in Group 3, 641 (51.4%) in Group 4 and 142 (11.4%) in Group 5]. Main predictors of rapid ART start (Group 1) were low CD4 cell count and high HIV-RNA at first contact with the infectious diseases centre. There was no association between probability of virological response and timing of ART initiation. Overall, 90% of individuals remained on ART after 1year, 91% with undetectable HIV-RNA. Participants of Italian nationality, those with higher CD4 cell count and lower HIV-RNA at ART initiation were more likely to be retained in care after 1year.Conclusions: In our high-income observational setting, we did not observe differences in the 1year rate of virological response and retention in care according to timing of ART initiation.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11369/446442
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