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

2019; Oxford University Press; Volume: 75; Issue: 3 Linguagem: Inglês

10.1093/jac/dkz512

1460-2091

Antonella d’Arminio Monforte, Alessandro Tavelli, Alessandro Cozzi‐Lepri, Antonella Castagna, Simone Passerini, Daniela Francisci, Annalisa Saracino, Franco Maggiolo, Giuseppe Lapadula, Enrico Girardi, Carlo Federico Perno, Andrea Antinori, Antonella d’Arminio Monforte, Andrea Antinori, Massimo Andreoni, Antonella Castagna, Francesco Castelli, Roberto Cauda, Giampaolo Perri, Massimo Galli, Rosaria Iardino, Giuseppe Ippolito, Adriano Lazzarin, Giulia Marchetti, Giovanni Rezza, F von Schloesser, P. Viale, Antonella d’Arminio Monforte, Andrea Antinori, Antonella Castagna, Francesca Ceccherini‐Silberstein, Alessandro Cozzi‐Lepri, Enrico Girardi, Sergio Lo Caputo, C Mussini, Massimo Puoti, Carlo Federico Perno, Andrea Antinori, Francesca Bai, Claudia Balotta, Alessandra Bandera, Stefano Bonora, Marco Borderi, Andrea Calcagno, Amedeo Capetti, Maria Rosaria Capobianchi, Antonella Castagna, Francesca Ceccherini‐Silberstein, S Cicalini, Antonella Cingolani, Paola Cinque, Alessandro Cozzi‐Lepri, Antonella d’Arminio Monforte, Andrea De Luca, Antonio Di Biagio, Enrico Girardi, Nicola Gianotti, Andrea Gori, G Guaraldi, Giuseppe Lapadula, Miriam Lichtner, Sergio Lo Caputo, Giordano Madeddu, Franco Maggiolo, Giulia Marchetti, Laura Monno, C Mussini, Silvia Nozza, Carlo Federico Perno, Carmela Pinnetti, Massimo Puoti, Eugenia Quirós-Roldán, Roberto Rossotti, Stefano Rusconi, Maria Mercedes Santoro, Annalisa Saracino, Loredana Sarmati, Alessandro Cozzi‐Lepri, Iuri Fanti, Laura Galli, P Lorenzini, A Rodano’, Marco Macchia, Alessandro Tavelli, Fabrizio Carletti, Silvia Carrara, Antonino Di, Silvia Graziano, F Petroni, Gennaro Prota, S Truffa, Andrea Giacometti, Andrea Costantini, V Barocci, Gioacchino Angarano, Laura Monno, Eugenio Milano, Franco Maggiolo, Claudia Suardi, P. Viale, Valentina Donati, G Verucchi, Filippo Castelnuovo, C Minardi, Eugenia Quirós-Roldán, Barbara Menzaghi, C Abeli, Bruno Cacopardo, Benedetto Maurizio Celesia, Jacopo Vecchiet, Katia Falasca, Angelo Pan, Silvia Lorenzotti, L Sighinolfi, Daniela Segala, P. Blanc, Francesca Vichi, Giovanni Cassola, Claudio Viscoli, A. Alessandrini, Nicoletta Bobbio, Giovanni Mazzarello, Miriam Lichtner, Laura Fondaco, Paolo Bonfanti, Chiara Molteni, Alessandro Chiodera, P Milini, Giuseppe Nunnari, Giovanni Francesco Pellicanò, Antonella d’Arminio Monforte, Massimo Galli, Adriano Lazzarin, Gloria Montenegro Rizzardini, Massimo Puoti, Antonella Castagna, Elvira Stefania Cannizzo, M C Moioli, R. Piolini, Dario Bernacchia, S Salpietro, Camilla Tincati, C Mussini, Cinzia Puzzolante, C Migliorino, Giuseppe Lapadula, Vincenzo Sangiovanni, Guglielmo Borgia, Vincenzo Esposito, G Di Flumeri, Ivan Gentile, Viviana Rizzo, Anna Maria Cattelan, Serena Marinello, Antonio Cascio, Marcello Trizzino, Daniela Francisci, Elisabetta Schiaroli, Giustino Parruti, Federica Sozio, G. Magnani, M A Ursitti, Massimo Andreoni, Andrea Antinori, Roberto Cauda, Antonio Cristaudo, Vincenzo Vullo, R Acinapura, Davide Moschese, M Capozzi, Annalisa Mondi, Antonella Cingolani, Marco Rivano Capparuccia, Giancarlo Iaiani, Alessandra Latini, Roberta Gagliardini, Maria Maddalena Plazzi, Giovanni de Girolamo, Alessandra Vergori, M Cecchetto, Franco Viviani, Giordano Madeddu, Andrea De Vito, Barbara Rossetti, Francesca Montagnani, Alfredo Franco‐Obregón, Rosario Vecchio, Giuliano Enzi, P Caramello, Giampaolo Perri, Stefano Bonora, Giancarlo Orofino, Mariangela Sciandra, Matteo Bassetti, AP Londero, Vinicio Manfrin, Giuliana Battagin, Giulio Starnini, A Ialungo,

HIV/AIDS drug development and treatment

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, >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 <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.