Too fast to stay on track? Shorter time to first anti-retroviral regimen is not associated with better retention in care in the French Dat'AIDS cohort

Rapid antiretroviral therapy (ART) initiation has been proven beneficial for patients and the community. We aimed to analyze recent changes in timing of ART initiation in France and consequences of early start. We selected from a prospective nationwide cohort, on 12/31/2017, patients with HIV-1 infe...

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Bibliographic Details
Published in:PloS one 2019-09, Vol.14 (9), p.e0222067-e0222067
Main Authors: Cuzin, L, Cotte, L, Delpierre, C, Allavena, C, Valantin, M-A, Rey, D, Delobel, P, Pugliese, P, Raffi, F, Cabié, A
Format: Article
Language:English
Subjects:
Acquired immune deficiency syndrome
Acquired Immunodeficiency Syndrome - drug therapy
Adult
AIDS
AIDS (Disease)
Analysis
Anti-HIV Agents - pharmacology
Anti-HIV Agents - therapeutic use
Antiretroviral agents
Antiretroviral drugs
Antiretroviral therapy
Biology and Life Sciences
Care and treatment
Cohort Studies
Diagnosis
Drug therapy
Female
France
Highly active antiretroviral therapy
HIV
HIV infections
HIV patients
Hospitals
Human health and pathology
Human immunodeficiency virus
Humans
Infection
Infectious diseases
Life Sciences
Male
Medical diagnosis
Medical research
Medicine and health sciences
Middle Aged
Mortality
Patients
People and places
Practice guidelines (Medicine)
Prospective Studies
Regression analysis
Retention
Retention in Care - statistics & numerical data
Society
Time Factors
Tropical diseases
Viral Load - drug effects
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Summary:Rapid antiretroviral therapy (ART) initiation has been proven beneficial for patients and the community. We aimed to analyze recent changes in timing of ART initiation in France and consequences of early start. We selected from a prospective nationwide cohort, on 12/31/2017, patients with HIV-1 infection diagnosed between 01/01/2010 and 12/31/2015. We described time from (1) diagnosis to first specialized medical encounter, (2) from this encounter to ART initiation, (3) from diagnosis to first undetectable HIV viral load (VL). We analyzed the determinants of measured temporal trends. A multivariate logistic regression was performed to assess characteristics related with 1-year retention in care. In the 7 245 included patients, median time (1) from HIV diagnosis to first medical encounter was 13 (IQR: 6-32) days, (2) to ART initiation was 27 (IQR: 9-91) days, decreasing from 42 (IQR: 13-272) days in 2010 to 18 (IQR: 7-42) in 2015 (p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0222067