Rapid HIV Viral Load Suppression in those Initiating Antiretroviral Therapy at First Visit after HIV Diagnosis.
Expert guidelines for antiretroviral therapy (ART) now recommend ART as soon as possible in all HIV infected persons to reduce the risk of disease progression and prevent transmission. The goal of this observational study was to evaluate the impact of very early ART initiation and regimen type on time to viral suppression. We evaluated time to viral suppression among 86 persons with newly-diagnosed HIV infection who initiated ART within 30 days of diagnosis. A total of 36 (42%) had acute, 27 (31%) early, and 23 (27%) had established HIV infection. The median time from an offer of immediate ART to starting ART was 8 days. A total of 56/86 (65%) initiated an integrase inhibitor-based regimen and 30/86 (35%) a protease inhibitor-based regimen. The time to viral suppression was significantly shorter in those receiving an integrase inhibitor- versus a protease inhibitor-based regimen (p = 0.022). Twenty-two (26%) initiated ART at their HIV care intake visit and 79% of these participants achieved viral suppression at week 12, 82% at week 24 and 88% at week 48. ART initiated at the intake visit led to rapid and reliable viral suppression in acute, early and chronic HIV infection, in particular when integrase inhibitor-based regimens were used.
Division of Infectious Diseases, Department of Medicine, University of California San Diego, San Diego, California, United States.|Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Graz, Austria.|Division of Pulmonology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
Martin
M
Hoenigl
Division of Infectious Diseases, Department of Medicine, University of California San Diego, San Diego, California, United States.
Antoine
A
Chaillon
Department of Psychiatry, University of California San Diego (UCSD), La Jolla, California, United States.
David J
DJ
Moore
Division of Infectious Diseases, Department of Medicine, University of California San Diego, San Diego, California, United States.
Sheldon R
SR
Morris
Division of Infectious Diseases, Department of Medicine, University of California San Diego, San Diego, California, United States.|Veterans Affairs Healthcare System, San Diego, California, United States.
Sanjay R
SR
Mehta
Division of Infectious Diseases, Department of Medicine, University of California San Diego, San Diego, California, United States.
Sara
S
Gianella
Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
K Rivet
KR
Amico
Division of Infectious Diseases, Department of Medicine, University of California San Diego, San Diego, California, United States.
Susan J
SJ
Little
D000328:Adult; D000368:Aged; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy*; D015497:HIV-1 / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D019562:Viral Load / Q000187:drug effects*; D055815:Young Adult