Rapid initiation of antiretroviral therapy at HIV diagnosis: definition, process, knowledge gaps.

Abstract:

:Initiating antiretroviral therapy (ART) as early as the day of HIV diagnosis is a strategy of increasing global interest to control the HIV epidemic and optimize the health of people living with HIV (PLWH). No detrimental effects of rapid-start ART have been identified in randomized controlled trials undertaken in low- or middle-income countries, or in cohort studies performed in high-income countries. Rapid-start ART may be a key approach in reaching the 2020 Joint United Nations Programme on HIV/AIDS goal of 90% of all PLWH knowing their status, 90% of those diagnosed receiving sustained ART, and 90% of those receiving ART achieving viral suppression; it may also be important for achieving the suggested fourth "90%" goal: improving health-related quality-of-life in PLWH. Presently there is insufficient broad evidence for guidelines to recommend universal test-and-treat strategies for all people, in all settings, at HIV diagnosis; consequently, there is a pressing need to conduct high-quality studies that investigate immediate ART initiation. This article evaluates global evidence regarding rapid-start ART, including same-day start, with particular focus on the implementation of this strategy in high-income countries.

journal_name

HIV Med

journal_title

HIV medicine

authors

Boyd MA,Boffito M,Castagna A,Estrada V

doi

10.1111/hiv.12708

subject

Has Abstract

pub_date

2019-03-01 00:00:00

pages

3-11

eissn

1464-2662

issn

1468-1293

journal_volume

20 Suppl 1

pub_type

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