Impact of the Coronavirus Disease 2019 Pandemic on Antiretroviral Therapy Initiation and Care Delivery for People With Newly Diagnosed HIV in an Integrated Healthcare System

Mohr, Kurtis B; Lee-Rodriguez, Christian; Samiezade-Yazd, Zahra; Lam, Jennifer O; Imp, Brandon; Luu, Mitchell N

doi:10.1093/ofid/ofac639

Cited by 1 publication

(1 citation statement)

References 13 publications

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“…Another limitation of our study is that a portion of the follow-up period occurred during the COVID-19 pandemic, which may have affected laboratory data, follow-up visits, and missing data. However, in a separate analysis of this study, no statistically significant differences were found in care delivery in our cohort before or during the COVID-19 pandemic [ 33 ]. Finally, there were missing data on viral load measurements for 9.7% of patients, which may have introduced bias into the analysis of cumulative viremic burden.…”

Section: Discussionmentioning

confidence: 95%

Outcomes and Predictors of Rapid Antiretroviral Therapy Initiation for People With Newly Diagnosed HIV in an Integrated Health Care System

Dalal,

Clark,

Samiezade-Yazd

et al. 2023

Open Forum Infectious Diseases

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Background Rapid antiretroviral therapy (ART) is the recommended treatment strategy for patients newly diagnosed with human immunodeficiency virus (HIV) but literature supporting this strategy focused on short-term outcomes. We examined both long-term outcomes and predictors of rapid ART among patients newly diagnosed with HIV within an integrated health care system in Northern California. Methods This observational cohort study included adults newly diagnosed with HIV between January 2015 and December 2020 at Kaiser Permanente Northern California. Rapid ART was defined as ART initiation within 7 days of HIV diagnosis. We collected demographic and clinical data to determine short-term and long-term outcomes, including viral suppression, care retention, medication adherence, and cumulative viral burden. Logistic regression models were used to identify predictors of rapid ART initiation. Results We enrolled 1,409 adults. 34.1% initiated rapid ART. The rapid ART group achieved viral suppression faster (48 vs 77 days, p < 0.001) and experienced lower cumulative viral burden (Log10viremia copy years 3.63 vs 3.82, p < 0.01), but had slightly reduced medication adherence (74.8% vs 75.2%, p < 0.01). There was no improvement in long term viral suppression and care retention in the rapid group during follow up. Patients were more likely to initiate rapid ART after 2017 and were less likely if they required an interpreter. Conclusions Patients who received rapid ART had improved cumulative HIV burden but no long-term improvement in care retention and viral suppression. Our findings suggest that rapid ART should be offered but additional interventions may be needed for patients newly diagnosed with HIV.

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Section: Discussionmentioning

confidence: 95%