Abstract:
OBJECTIVES:Rapid initiation of antiretroviral therapy (ART) engenders faster viral suppression but with suboptimal rates of durable viral suppression and engagement in care, as reported by clinical trials in resource-limited settings. Real-world experience with rapid ART initiation remains limited in resource-rich settings. DESIGN:Retrospective cohort study. SETTING:A tertiary hospital in metropolitan Taipei, Taiwan. PARTICIPANTS:We included 631 patients newly diagnosed as having HIV infection between March 2014 and July 2018. MAIN OUTCOME MEASURES:Rapid ART initiation was defined as starting ART within 7 days after HIV diagnosis confirmation. HIV diagnosis, ART initiation and viral suppression dates and clinical outcome data were collected by reviewing medical records. The rates of loss to follow-up (LTFU), engagement in care and virological rebound at 12 months were compared between patients with rapid ART initiation and those with standard initiation. RESULTS:Rapid ART initiation increased from 33.8% in 2014 to 68.3% in 2017, and the median interval between HIV diagnosis and viral suppression (HIV RNA load <200 copies/mL) decreased from 138 to 47 days. Patients with rapid ART initiation had a significantly higher rate of engagement in care at 12 months than did those with standard initiation (88.3% vs 79.0%; p=0.002). Patients aged <30 years had a higher risk of LTFU (HR: 2.19; 95% CI 1.20 to 3.98); and rapid ART initiation was associated with a lower risk of LTFU (HR: 0.41; 95% CI 0.24 to 0.83). Patients aged <30 years were more likely to acquire incident sexually transmitted infections (STIs) before achieving viral suppression. CONCLUSIONS:Rapid ART initiation was associated with a higher rate of engagement in care at 12 months and shortened interval from diagnosis to HIV suppression. Delayed ART initiation may increase onwards HIV transmission considering the high rates of STIs. ETHICS APPROVAL:The study was approved by the Research Ethics Committee of National Taiwan University Hospital (Registration No. 201003112R).
journal_name
BMJ Openjournal_title
BMJ openauthors
Huang YC,Sun HY,Chuang YC,Huang YS,Lin KY,Huang SH,Chen GJ,Luo YZ,Wu PY,Liu WC,Hung CC,Chang SCdoi
10.1136/bmjopen-2019-033246subject
Has Abstractpub_date
2019-09-20 00:00:00pages
e033246issue
9issn
2044-6055pii
bmjopen-2019-033246journal_volume
9pub_type
杂志文章相关文献
BMJ Open文献大全abstract:OBJECTIVES:To investigate medical student's self-efficacy at the time of finishing their rural clinical school (RCS) placement and factors associated with self-efficacy. Secondary aims are to explore whether interest levels or self-efficacy are associated with rural or remote career intentions. DESIGN, SETTING AND PAR...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2015-009574
更新日期:2015-12-15 00:00:00
abstract:PURPOSE:Despite the growing evidence that physical activity and familial factors play a role in low back pain (LBP), there is a lack of robust longitudinal studies that (1) investigate the types and dosages of physical activity that are protective or harmful for LBP, (2) employ objective measures of physical activity a...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-036301
更新日期:2020-07-28 00:00:00
abstract:INTRODUCTION:With almost 50% of cases preventable and the Australian National Bowel Cancer Screening Program in place, colorectal cancer (CRC) is a prime candidate for investment to reduce the cancer burden. The challenge is determining effective ways to reduce morbidity and mortality and their implementation through p...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-036475
更新日期:2020-06-21 00:00:00
abstract:INTRODUCTION:Delayed graft function due to ischaemia-reperfusion injury is a frequent complication in deceased donor renal transplantation. Experimental evidence indicates that remote ischaemic conditioning (RIC) provides systemic protection against ischaemia-reperfusion injury in various tissues. METHODS AND ANALYSIS...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmjopen-2015-007941
更新日期:2015-08-20 00:00:00
abstract:OBJECTIVE:Hepatitis B reactivation (HBr) is strongly associated with rituximab therapy. Guidelines advise hepatitis B screening and use of preventive nucleoside analogue (NA) in patients at risk. In this study, we examined screening trends, post-screening interventions and outcomes in patients receiving rituximab in li...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2020-043672
更新日期:2020-12-15 00:00:00
abstract:OBJECTIVES:To analyse the prevalence and incidence of pregabalin and gabapentin (P/G) prescriptions, typical therapeutic uses of P/G with special attention to pain-related diagnoses and discontinuation rates. DESIGN:Secondary data analysis. SETTING:Primary and secondary care in Germany. PARTICIPANTS:Four million pat...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-021535
更新日期:2019-03-30 00:00:00
abstract:OBJECTIVE:The aim of this pilot study was to determine risk factors, including Staphylococcus aureus nasal carriage, for dermatitis in submariners during a submarine patrol. PARTICIPANTS AND METHODS:36 submariners undertaking a submerged 6-week patrol participated in the study. Severity of dermatitis and its impact wa...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2015-010975
更新日期:2016-06-02 00:00:00
abstract:INTRODUCTION:Controlled trials support the efficacy of exercise as a treatment modality for chronic conditions, yet effectiveness of real-world Exercise Physiology services is yet to be determined. This study will investigate the efficacy and cost-effectiveness of services provided by Accredited Exercise Physiologists ...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-027610
更新日期:2019-08-21 00:00:00
abstract:OBJECTIVE:Podoconiosis is a neglected tropical disease characterised by a slowly progressive swelling of the foot and lower leg. It is prevalent among subsistence barefoot farmers who live and work in highland areas of the tropics. This study was conducted in Wayu Tuka 'woreda' (district), western Ethiopia to determine...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2016-012308
更新日期:2016-09-26 00:00:00
abstract:OBJECTIVE:To examine the role of dietary intake and physical activity in muscle strength among adolescents. DESIGN:Cross-sectional analysis. SETTING:The Malaysian Health and Adolescents Longitudinal Research Team (MyHeART) study. PARTICIPANTS:Fifteen-year-old secondary school children who have given consent and who ...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-026275
更新日期:2019-06-27 00:00:00
abstract:OBJECTIVE:Prenatal exposure to antiepileptic drugs (AEDs) has been associated with adverse outcomes in the offspring such as congenital malformations and neuropsychiatric disorders. The objective of this study was to investigate whether prenatal exposure to AEDs is also associated with more frequent use of primary heal...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2016-012836
更新日期:2017-01-05 00:00:00
abstract:OBJECTIVES:We previously demonstrated that a calcium channel blocker, azelnidipine, improves left ventricular relaxation in patients with hypertension and diastolic dysfunction in a multicentre, Clinical impact of Azelnidipine on Left VentricuLar diastolic function and OutComes in patients with hypertension (CALVLOC) t...
journal_title:BMJ open
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1136/bmjopen-2014-006136
更新日期:2014-09-30 00:00:00
abstract:OBJECTIVE:To examine the impact of caesarean section on breastfeeding indicators-early initiation of breastfeeding, exclusive breastfeeding under 6 months and children ever breastfed (at least once)-in sub-Saharan Africa. DESIGN:Secondary analysis of Demographic and Health Surveys (DHS). SETTING:Thirty-three low-inco...
journal_title:BMJ open
pub_type: 杂志文章,meta分析
doi:10.1136/bmjopen-2018-027497
更新日期:2019-09-04 00:00:00
abstract:OBJECTIVES:Previous qualitative research investigating the experiences of women diagnosed with gestational diabetes (GD) has provided important insights into the development of behaviour change interventions. However, these studies often lack a theoretical underpinning. This study explored the use of the capability, op...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2020-037318
更新日期:2020-08-04 00:00:00
abstract:OBJECTIVE:This study aims to assess the needs of people with disabilities and their level of inclusion in social protection programmes. DESIGN:Population based-survey with a nested case-control study. SETTING:Morropon, a semiurban district located in Piura, northern Peru. PARTICIPANTS:For the population survey, a tw...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2016-011300
更新日期:2016-08-26 00:00:00
abstract:OBJECTIVES:Few studies have investigated the prevalence of adverse drug reactions (ADRs) leading to hospitalisation in Japan. The aim of this study was to determine the prevalence of ADRs leading to hospitalisation and to evaluate the preventability of these ADRs in Japan. DESIGN:A single-centre cross-sectional study ...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-030515
更新日期:2019-08-05 00:00:00
abstract:OBJECTIVES:The aim of this study was to provide recommendations to hospital owners and employee unions about developing efficient, sustainable and safe work-hour agreements. Employees at two clinics of a hospital, one a non-intensive care and the other a newborn intensive care unit (ICU), trialled 12-hour shifts on wee...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-024292
更新日期:2019-07-09 00:00:00
abstract:OBJECTIVES:To develop an algorithm that aims to provide guidance and awareness for choosing multiple study designs in systematic reviews of healthcare interventions. DESIGN:Method study: (1) To summarise the literature base on the topic. (2) To apply the integration of various study types in systematic reviews. (3) To...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2014-007540
更新日期:2015-08-19 00:00:00
abstract:OBJECTIVES:To systematically analyse the effect of pharmacological treatment of hypertension (HTN) on cognitive decline in older adults. METHODS:Randomised, placebo-controlled trials with a prespecified quantitative outcome of cognition and a pharmacological intervention for at least 12 months to treat HTN in older ad...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2020-038971
更新日期:2020-11-17 00:00:00
abstract:OBJECTIVES:The reliability of ultrasonic strain elastography (SEL) used to detect abnormalities in the supraspinatus tendon is unclear. Thus, the aim of this study was to investigate the reliability of SEL in the supraspinatus tendon. DESIGN:An intra-rater and inter-rater reliability study. SETTING:A single-centre st...
journal_title:BMJ open
pub_type: 临床试验,杂志文章
doi:10.1136/bmjopen-2018-027725
更新日期:2019-05-09 00:00:00
abstract:OBJECTIVE:To determine the effect of preoperative patient and hospital factors on resource use, cost and length of stay (LOS) among patients undergoing off-pump coronary artery bypass grafting (OPCAB). DESIGN:Observational retrospective study. SETTINGS:Data from the Japanese Administrative Database. PARTICIPANTS:Pat...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2015-008750
更新日期:2015-11-17 00:00:00
abstract:OBJECTIVE:To assess the impact of chronic kidney disease (CKD) and cardiovascular comorbidity on mortality in a multiethnic primary care population. DESIGN:Retrospective cohort study. SETTING:Inner-city primary care trust in West Midlands, UK. PARTICIPANTS:Individuals aged 40 years and older, of South Asian, black o...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2013-003458
更新日期:2013-12-03 00:00:00
abstract:OBJECTIVES:There is an increasing trend in the use of electronic health records (EHRs) for clinical research. However, more knowledge is needed on how to assure and improve data quality. This study aimed to explore healthcare professionals' experiences and perceptions of barriers and facilitators of data quality of EHR...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究
doi:10.1136/bmjopen-2019-029314
更新日期:2019-07-02 00:00:00
abstract:OBJECTIVES:To describe the effect of in utero exposure to the buprenorphine+naloxone combination product in a rural and remote population. SETTING:A district hospital that services rural and remote, fly-in communities in Northwestern Ontario, Canada. PARTICIPANTS:A retrospective cohort study was conducted of 855 moth...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2016-011774
更新日期:2016-10-31 00:00:00
abstract:OBJECTIVE:We report on: (1) the proportion of patients with known atrial fibrillation (AF); and (2) demographic, clinical or radiological differences between patients with known AF (and not treated) and patients with newly diagnosed AF, in a cohort of patients who presented with ischaemic stroke or transient ischaemic ...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究
doi:10.1136/bmjopen-2018-028387
更新日期:2019-07-24 00:00:00
abstract:INTRODUCTION:Emergency admission risk prediction models are increasingly used to identify patients, typically with one or more chronic conditions, for proactive management in primary care to avoid admissions, save costs and improve patient experience. AIM:To identify and review the published evidence on the costs, eff...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2015-009653
更新日期:2016-03-01 00:00:00
abstract:OBJECTIVE:To quantify the effects of increased cycling on both mortality and morbidity. DESIGN:Health Impact Assessment. SETTING:Cycling to place of work or education in Copenhagen, Denmark. POPULATION:Effects were calculated based on the working-age population of Copenhagen. MAIN OUTCOME MEASURES:The primary outco...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2012-001135
更新日期:2012-07-24 00:00:00
abstract:OBJECTIVE:To analyse the association between different domains of physical activity (PA) and health-related domains of health-related quality of life (HRQoL) in older adults, independent of confounding variables. DESIGN:Cross-sectional study. PARTICIPANTS:In total, 400 individuals 60 years or above were randomly sele...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-027751
更新日期:2019-06-27 00:00:00
abstract:OBJECTIVES:To report the distribution and predictors of insulin resistance (IR) in young people presenting to primary care-based mental health services. DESIGN:Cross-sectional. SETTING:Headspace-linked clinics operated by the Brain and Mind Centre of the University of Sydney. PARTICIPANTS:768 young people (66% femal...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-025674
更新日期:2019-05-27 00:00:00
abstract:INTRODUCTION:Prescription-drug use in the USA has increased by more than 60% in the last three decades. Prevalence of prescription-drug use among pregnant women is currently estimated around 50%. Prevalence of illicit drug use in the USA is 14.6% among pregnant adolescents, 8.6% among pregnant young adults and 3.2% amo...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究
doi:10.1136/bmjopen-2017-020248
更新日期:2018-02-17 00:00:00