Comparison of Immunological and Virological Recovery with Rapid, Early, and Late Start of Antiretroviral Treatment in Naive Plwh: Real-World Data

Abstract

Background

Rapid initiation of antiretroviral therapy (ART) reduces the transmission of HIV infection in the community. This study aimed to determine whether rapid ART initiation is effective compared to standard ART treatment in our country.

Methods

Patients were grouped based on time to treatment initiation. HIV RNA levels, CD+4 T cell count, CD4/CD8 ratio, and ART regimens were recorded at baseline and follow-up visits for 12 months.

Results

There were 368-ART naive adults (treatment initiated at the time of HIV diagnosis; 143 on the first day, 48 on the second-seventh day, and 177 after the seventh day). Although virological suppression rates at 12^th months were higher in all groups, over 90% on average, there were no statistically significant differences in HIV-1 RNA suppression rates, CD+4 T cell count, and CD4/CD8 ratio normalization in the studied months but in multivariate logistic regression analysis; showed a significant correlation between both virological and immunological response and those with CD4+ T <350 cells/mL at 12th month in total patients.

Conclusion

Our findings support the broader application of recommendations for rapid ART initiation in HIV patients.

Keywords:

• HIV
• ART
• antiretroviral
• rapid start

Data Sharing Statement

The authors hereby confirm that the data supporting the results and findings of this study are available within the article.

Ethics Approval

Ethics committee approval was obtained at Health Sciences University Antalya Research and Training.

Hospital in Turkey in accordance with the 2008 Declaration of Helsinki (Registration No: 06.05.2021 6/11). The requirement for written informed consent was waived because of the retrospective design of this study. Demographic information and laboratory analysis were collected from medical records. We confirmed that all the data was anonymized and maintained with confidentiality.

Consent for Publication

Individual consent was not mandatory as this was a record-based study. No individual data was captured.

Human and Animal Rights

No animals were used in this research. All human research procedures were in accordance with the articles set forth in the Declaration of Helsinki of 1975, as revised in 2013 (http://ethics.iit.edu/ecodes/node/3931).

Standard of Reporting

The study conforms to the STROBE guidelines.

Acknowledgment

We would like to thank İlker Kürkçü for statistical analysis support.

Disclosure

The authors declare no conflicts of interest, financial or otherwise.