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d’Arminio Monforte, Antonella; Tavelli, Alessandro; Cozzi-Lepri, Alessandro; Castagna, Antonella; Passerini, Simone; Francisci, Daniela; Saracino, Annalisa; Maggiolo, Franco; Lapadula, Giuseppe; Girardi, Enrico; Perno, Carlo Federico; Antinori, Andrea; d’Arminio Monforte, A; Antinori, A; Andreoni, M; Castagna, A; Castelli, F; Cauda, R; Di Perri, G; Galli, M; Iardino, R; Ippolito, G; Lazzarin, A; Marchetti, G C; [...]

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

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  • Media type: E-Article
  • Title: Virological response and retention in care according to time of starting ART in Italy: data from the Icona Foundation Study cohort
  • Contributor: d’Arminio Monforte, Antonella; Tavelli, Alessandro; Cozzi-Lepri, Alessandro; Castagna, Antonella; Passerini, Simone; Francisci, Daniela; Saracino, Annalisa; Maggiolo, Franco; Lapadula, Giuseppe; Girardi, Enrico; Perno, Carlo Federico; Antinori, Andrea; d’Arminio Monforte, A; Antinori, A; Andreoni, M; Castagna, A; Castelli, F; Cauda, R; Di Perri, G; Galli, M; Iardino, R; Ippolito, G; Lazzarin, A; Marchetti, G C; [...]
  • imprint: Oxford University Press (OUP), 2020
  • Published in: Journal of Antimicrobial Chemotherapy
  • Language: English
  • DOI: 10.1093/jac/dkz512
  • ISSN: 0305-7453; 1460-2091
  • Keywords: Infectious Diseases ; Pharmacology (medical) ; Pharmacology ; Microbiology (medical)
  • Origination:
  • Footnote:
  • Description: <jats:title>Abstract</jats:title> <jats:sec> <jats:title>Objectives</jats:title> <jats:p>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.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>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, &amp;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 &amp;lt;50 copies/mL).</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>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.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>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.</jats:p> </jats:sec>
  • Access State: Open Access