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

6533b7d4fe1ef96bd1262ab2

RESEARCH PRODUCT

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

A. D'arminio Monforte A. Tavelli A. Cozzi-lepri A. Castagna S. Passerini D. Francisci A. Saracino F. Maggiolo G. Lapadula E. Girardi C. F. Perno A. Antinori A. D'arminio Monforte A. Antinori M. Andreoni A. Castagna F. Castelli R. Cauda G. Di Perri M. Galli R. Iardino G. Ippolito A. Lazzarin G. C. Marchetti G. Rezza F. Von Schloesser P. Viale A. D'arminio Monforte A. Antinori A. Castagna F. Ceccherini-silberstein A. Cozzi-lepri E. Girardi S. Lo Caputo C. Mussini M. Puoti C. F. Perno A. Antinori F. Bai C. Balotta A. Bandera S. Bonora M. Borderi A. Calcagno A. Capetti M. R. Capobianchi A. Castagna F. Ceccherini-silberstein S. Cicalini A. Cingolani P. Cinque A. Cozzi-lepri A. D'arminio Monforte A. De Luca A. Di Biagio E. Girardi N. Gianotti A. Gori G. Guaraldi G. Lapadula M. Lichtner S. Lo Caputo G. Madeddu F. Maggiolo G. Marchetti L. Monno C. Mussini S. Nozza C. F. Perno C. Pinnetti M. Puoti E. Quiros Roldan R. Rossotti S. Rusconi M. M. Santoro A. Saracino L. Sarmati A. Cozzi-lepri I. Fanti L. Galli P. Lorenzini A. Rodano M. Macchia A. Tavelli F. Carletti S. Carrara A. Di Caro S. Graziano F. Petroni G. Prota S. Truffa A. Giacometti A. Costantini V. Barocci G. Angarano L. Monno E. Milano F. Maggiolo C. Suardi P. Viale V. Donati G. Verucchi F. Castelnuovo C. Minardi E. Quiros Roldan B. Menzaghi C. Abeli B. Cacopardo B. Celesia J. Vecchiet K. Falasca A. Pan S. Lorenzotti L. Sighinolfi D. Segala P. Blanc F. Vichi G. Cassola C. Viscoli A. Alessandrini N. Bobbio G. Mazzarello M. Lichtner L. Fondaco P. Bonfanti C. Molteni A. Chiodera P. Milini G. Nunnari G. Pellicano A. D'arminio Monforte M. Galli A. Lazzarin G. Rizzardini M. Puoti A. Castagna E. S. Cannizzo M. C. Moioli R. Piolini D. Bernacchia S. Salpietro C. Tincati C. Mussini C. Puzzolante C. Migliorino G. Lapadula V. Sangiovanni G. Borgia V. Esposito G. Di Flumeri I. Gentile V. Rizzo A. M. Cattelan S. Marinello A. Cascio M. Trizzino D. Francisci E. Schiaroli G. Parruti F. Sozio G. Magnani M. A. Ursitti M. Andreoni A. Antinori R. Cauda A. Cristaudo V. Vullo R. Acinapura D. Moschese M. Capozzi A. Mondi A. Cingolani M. Rivano Capparuccia G. Iaiani A. Latini R. Gagliardini M. M. Plazzi G. De Girolamo A. Vergori M. Cecchetto F. Viviani G. Madeddu A. De Vito B. Rossetti F. Montagnani A. Franco R. Fontana Del Vecchio C. Di Giuli P. Caramello G. Di Perri S. Bonora G. C. Orofino M. Sciandra M. Bassetti A. Londero V. Manfrin G. Battagin G. Starnini A. Ialungo

subject

0301 basic medicine diagnosis hiv communicable diseases HIV Infections Logistic regression Virological response Cohort Studies 0302 clinical medicine Retention in Care Medicine Pharmacology (medical)HIV Infection 030212 general & internal medicine Prospective cohort study cd4 count determination procedure drug suppression Viral Load CD4 Lymphocyte Count; Cohort Studies; Humans; Italy; Viral Load; Anti-HIV Agents; HIV Infections; Retention in Care virology Infectious Diseases Italy blood hiv rna Cohort hiv cd4 count determination procedure communicable diseases incomeitaly diagnosis virology blood hiv rna retention in care incomeitaly Viral load HIV ART Cohort study Human Microbiology (medical)medicine.medical_specialty Anti-HIV Agents antiretroviral therapy Settore MED/17 - MALATTIE INFETTIVE NO 03 medical and health sciences HIV viral load Internal medicine Humans HIV CD4 ART Pharmacology business.industry double blind Anti-HIV Agent HIV viral load antiretroviral therapy double blind initiation suppression infection Retention in care 030112 virology infection initiation CD4 Lymphocyte Count Observational study Cohort Studie business

description

Abstract Objectives To describe: (i) factors associated with rapid and delayed ART initiation; (ii) rates of 12 week virological response; and (iii) virologically controlled retention in care by 1 year 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, ≤7 days; Group 2, 8–14 days; Group 3, 15–30 days; Group 4, 31–120 days; and Group 5, &gt;120 days. 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 12 week virological response (by a modified snapshot algorithm); and (iii) the probability of retention in care at 1 year (on ART with HIV-RNA &lt;50 copies/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 1 year, 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 1 year. Conclusions In our high-income observational setting, we did not observe differences in the 1 year rate of virological response and retention in care according to timing of ART initiation.

year	journal	country	edition	language
2020-01-01

10.1093/jac/dkz512 http://hdl.handle.net/11391/1459692