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Same-day ART initiation as a predictor of loss to follow-up and viral suppression among people living with HIV in sub-Saharan Africa

dc.rights.licenseopenen_US
dc.contributor.authorROSS, Jonathan
dc.contributor.authorBRAZIER, Ellen
dc.contributor.authorFATTI, Geoffrey
hal.structure.identifierBordeaux population health [BPH]
hal.structure.identifierGlobal Health in the Global South [GHiGS]
dc.contributor.authorJAQUET, Antoine
ORCID: 0000-0002-1127-220X
IDREF: 120590344
dc.contributor.authorTANON, Aristophane
dc.contributor.authorHAAS, Andreas D.
dc.contributor.authorDIERO, Lameck
dc.contributor.authorCASTELNUOVO, Barbara
dc.contributor.authorYIANNOUTSOS, Constantin T.
dc.contributor.authorNASH, Denis
dc.contributor.authorANASTOS, Kathryn M.
dc.contributor.authorYOTEBIENG, Marcel
dc.date.accessioned2022-11-02T10:29:34Z
dc.date.available2022-11-02T10:29:34Z
dc.date.issued2022-09-13
dc.identifier.issn1537-6591 (Electronic) 1058-4838 (Linking)en_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/170191
dc.description.abstractEnBACKGROUND: Treat-All guidelines recommend initiation of antiretroviral therapy (ART) for all people living with HIV (PLHIV) on the day of diagnosis when possible, yet uncertainty exists about the impact of same-day ART initiation on subsequent care engagement. We examined the association of same-day ART initiation with loss to follow-up and viral suppression among patients in 11 sub-Saharan African countries. METHODS: We included ART-naïve adult PLHIV from sites participating in the International epidemiology Databases to Evaluate AIDS consortium (IeDEA) who enrolled in care after Treat-All implementation and prior to January 2019. We used multivariable Cox regression to estimate the association between same-day ART initiation and loss to follow-up, and Poisson regression to estimate the association between same-day ART initiation and 6-month viral suppression. RESULTS: Among 29,017 patients from 63 sites, 18,584 (64.0%) initiated ART on the day of enrollment. Same-day ART initiation was less likely among those with advanced HIV disease versus early-stage disease. Loss to follow-up was significantly lower among those initiating ART ≥1 day of enrollment, compared with same-day ART initiators (20.6% vs 27.7%; adjusted hazard ratio 0.66, 95% CI 0.57-0.76). No difference in viral suppression was observed by time to ART initiation (adjusted rate ratio 1.00, 95% CI 0.98-1.02). CONCLUSIONS: Patients initiating ART on the day of enrollment were more frequently lost to follow-up than those initiating later but were equally likely to be virally suppressed. Our findings support recent WHO recommendations for providing tailored counseling and support to patients who accept an offer of same-day ART.
dc.language.isoENen_US
dc.subject.enAntiretroviral therapy
dc.subject.enTreat-All
dc.subject.enSub-Saharan Africa
dc.subject.enLoss to follow-up
dc.title.enSame-day ART initiation as a predictor of loss to follow-up and viral suppression among people living with HIV in sub-Saharan Africa
dc.typeArticle de revueen_US
dc.identifier.doi10.1093/cid/ciac759en_US
dc.subject.halSciences du Vivant [q-bio]/Santé publique et épidémiologieen_US
dc.identifier.pubmed36097726en_US
bordeaux.journalClinical Infectious Diseasesen_US
bordeaux.hal.laboratoriesBordeaux Population Health Research Center (BPH) - UMR 1219en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.institutionINSERMen_US
bordeaux.teamGHIGS_BPHen_US
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
hal.identifierhal-03836546
hal.version1
hal.date.transferred2023-06-29T12:59:50Z
hal.exporttrue
dc.rights.ccPas de Licence CCen_US
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