Timeliness of antiretroviral therapy initiation in the era before universal treatment

Abstract We assessed the prevalence and factors related to the time to antiretroviral (ART) initiation among persons who entered HIV care and subsequently started ART in Croatia from 2005 to 2014. Included were patients ≥ 18 years, the follow-up ended on Dec/31/2017. 628 patients were included into...

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Autores principales:	Nikolina Bogdanić, Liam Bendig, Davorka Lukas, Šime Zekan, Josip Begovac
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/17695de0b5634c5c822b97f32e44e657
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spelling	oai:doaj.org-article:17695de0b5634c5c822b97f32e44e6572021-12-02T15:45:16ZTimeliness of antiretroviral therapy initiation in the era before universal treatment10.1038/s41598-021-90043-72045-2322https://doaj.org/article/17695de0b5634c5c822b97f32e44e6572021-05-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-90043-7https://doaj.org/toc/2045-2322Abstract We assessed the prevalence and factors related to the time to antiretroviral (ART) initiation among persons who entered HIV care and subsequently started ART in Croatia from 2005 to 2014. Included were patients ≥ 18 years, the follow-up ended on Dec/31/2017. 628 patients were included into the study 91.9% were men; median age was 36.1 (Q1–Q3: 29.6–43.8) years. Rapid (within 7 days of diagnosis) ART initiation was observed in 21.8% patients, 49.8% initiated ART within 30 days, 21.7% and 28.5% had intermediate (31 days–1 year) and late initiation (> 1 year), respectively. Of 608 patients that achieved an undetectable viral load, 94% had a plasma HIV-1 RNA < 50 copies/ml at last measurement after a median follow-up of 5.2 years. On quantile regression analysis, calendar year of entry into care, and markers of more advanced HIV disease (higher viral load, lower CD4 cell count and clinical AIDS) were significantly associated with earlier ART initiation. Early ART was not related to a gap in care afterwards at all quantiles. In conclusion, a significant proportion of patients started ART early in Croatia in 2005–2014. Early ART initiation led to durable viral load suppression and was not associated with a subsequent gap in care.Nikolina BogdanićLiam BendigDavorka LukasŠime ZekanJosip BegovacNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Nikolina Bogdanić Liam Bendig Davorka Lukas Šime Zekan Josip Begovac Timeliness of antiretroviral therapy initiation in the era before universal treatment
description	Abstract We assessed the prevalence and factors related to the time to antiretroviral (ART) initiation among persons who entered HIV care and subsequently started ART in Croatia from 2005 to 2014. Included were patients ≥ 18 years, the follow-up ended on Dec/31/2017. 628 patients were included into the study 91.9% were men; median age was 36.1 (Q1–Q3: 29.6–43.8) years. Rapid (within 7 days of diagnosis) ART initiation was observed in 21.8% patients, 49.8% initiated ART within 30 days, 21.7% and 28.5% had intermediate (31 days–1 year) and late initiation (> 1 year), respectively. Of 608 patients that achieved an undetectable viral load, 94% had a plasma HIV-1 RNA < 50 copies/ml at last measurement after a median follow-up of 5.2 years. On quantile regression analysis, calendar year of entry into care, and markers of more advanced HIV disease (higher viral load, lower CD4 cell count and clinical AIDS) were significantly associated with earlier ART initiation. Early ART was not related to a gap in care afterwards at all quantiles. In conclusion, a significant proportion of patients started ART early in Croatia in 2005–2014. Early ART initiation led to durable viral load suppression and was not associated with a subsequent gap in care.
format	article
author	Nikolina Bogdanić Liam Bendig Davorka Lukas Šime Zekan Josip Begovac
author_facet	Nikolina Bogdanić Liam Bendig Davorka Lukas Šime Zekan Josip Begovac
author_sort	Nikolina Bogdanić
title	Timeliness of antiretroviral therapy initiation in the era before universal treatment
title_short	Timeliness of antiretroviral therapy initiation in the era before universal treatment
title_full	Timeliness of antiretroviral therapy initiation in the era before universal treatment
title_fullStr	Timeliness of antiretroviral therapy initiation in the era before universal treatment
title_full_unstemmed	Timeliness of antiretroviral therapy initiation in the era before universal treatment
title_sort	timeliness of antiretroviral therapy initiation in the era before universal treatment
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/17695de0b5634c5c822b97f32e44e657
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Timeliness of antiretroviral therapy initiation in the era before universal treatment

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