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Tytuł:
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Decreased Time to Viral Suppression After Implementation of Targeted Testing and Immediate Initiation of Treatment of Acute Human Immunodeficiency Virus Infection Among Men Who Have Sex With Men in Amsterdam.
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Autorzy:
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Dijkstra M; Department of Infectious Diseases, Public Health Service, Amsterdam, The Netherlands.; Division of Infectious Diseases, Department of Internal Medicine, Amsterdam Institute for Infection and Immunity, Amsterdam University Medical Center, University of Amsterdam, The Netherlands.
van Rooijen MS; Department of Infectious Diseases, Public Health Service, Amsterdam, The Netherlands.
Hillebregt MM; Stichting HIV Monitoring, Amsterdam, The Netherlands.
van Sighem A; Stichting HIV Monitoring, Amsterdam, The Netherlands.
Smit C; Stichting HIV Monitoring, Amsterdam, The Netherlands.
Hogewoning A; Department of Infectious Diseases, Public Health Service, Amsterdam, The Netherlands.; Division of Infectious Diseases, Department of Internal Medicine, Amsterdam Institute for Infection and Immunity, Amsterdam University Medical Center, University of Amsterdam, The Netherlands.
Davidovich U; Department of Infectious Diseases, Public Health Service, Amsterdam, The Netherlands.; Division of Infectious Diseases, Department of Internal Medicine, Amsterdam Institute for Infection and Immunity, Amsterdam University Medical Center, University of Amsterdam, The Netherlands.
Heijman T; Department of Infectious Diseases, Public Health Service, Amsterdam, The Netherlands.
Hoornenborg E; Department of Infectious Diseases, Public Health Service, Amsterdam, The Netherlands.
Reiss P; Division of Infectious Diseases, Department of Internal Medicine, Amsterdam Institute for Infection and Immunity, Amsterdam University Medical Center, University of Amsterdam, The Netherlands.; Stichting HIV Monitoring, Amsterdam, The Netherlands.; Department of Global Health, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands.; Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands.
van der Valk M; Division of Infectious Diseases, Department of Internal Medicine, Amsterdam Institute for Infection and Immunity, Amsterdam University Medical Center, University of Amsterdam, The Netherlands.
Prins M; Department of Infectious Diseases, Public Health Service, Amsterdam, The Netherlands.; Division of Infectious Diseases, Department of Internal Medicine, Amsterdam Institute for Infection and Immunity, Amsterdam University Medical Center, University of Amsterdam, The Netherlands.
Prins JM; Division of Infectious Diseases, Department of Internal Medicine, Amsterdam Institute for Infection and Immunity, Amsterdam University Medical Center, University of Amsterdam, The Netherlands.
Schim van der Loeff MF; Department of Infectious Diseases, Public Health Service, Amsterdam, The Netherlands.; Division of Infectious Diseases, Department of Internal Medicine, Amsterdam Institute for Infection and Immunity, Amsterdam University Medical Center, University of Amsterdam, The Netherlands.
de Bree GJ; Division of Infectious Diseases, Department of Internal Medicine, Amsterdam Institute for Infection and Immunity, Amsterdam University Medical Center, University of Amsterdam, The Netherlands.
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Corporate Authors:
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HIV Transmission Elimination Amsterdam (H-TEAM) Initiative
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Źródło:
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Clinical infectious diseases : an official publication of the Infectious Diseases Society of America [Clin Infect Dis] 2021 Jun 01; Vol. 72 (11), pp. 1952-1960.
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Typ publikacji:
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Journal Article; Research Support, Non-U.S. Gov't
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Język:
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English
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Imprint Name(s):
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Publication: Jan. 2011- : Oxford : Oxford University Press
Original Publication: Chicago, IL : The University of Chicago Press, c1992-
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MeSH Terms:
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HIV Infections*/diagnosis
HIV Infections*/drug therapy
Sexual and Gender Minorities*
Antiretroviral Therapy, Highly Active ; CD4 Lymphocyte Count ; Homosexuality, Male ; Humans ; Male ; Viral Load
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Contributed Indexing:
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Investigator: JEAM van Bergen; P Brokx; F Deug; M Heidenrijk; M Prins; P Reiss; M van der Valk; JEAM van Bergen; GJ de Bree; P Brokx; U Davidovich; SE Geerlings; E Hoornenborg; A Oomen; A van Sighem; W Zuilhof; N Schat; RCA Achterbergh; M van Agtmael; J Ananworanich; D Van de Beek; GEL van den Berk; D Bezemer; A van Bijnen; WL Blok; S Bogers; M Bomers; CAB Boucher; W Brokking; D Burger; K Brinkman; N Brinkman; M de Bruin; S Bruisten; L Coyer; R van Crevel; CG Daans; L Dellemann; M Dijkstra; YT van Duijnhoven; A van Eeden; L Elsenburg; MAM van den Elshout; C Ester; E Ersan; PEV Felipa; PHJ Frissen; TBH Geijtenbeek; MH Godfried; J van Goo; A Goorhuis; M Groot; CA Hankins; A Heijnen; MMJ Hillebregt; A Hogewoning; M Hommenga; JW Hovius; Y Janssen; K de Jong; V Jongen; NA Kootstra; RA Koup; FP Kroon; TJW van de Laar; F Lauw; MM van Leeuwen; K Lettinga; I Linde; DSE Loomans; JT van der Meer; T Mouhebati; BJ Mulder; J Mulder; FJ Nellen; A Nijsters; H Nobel; P Oostvogel; ELM Op de Coul; E Peters; IS Peters; T van der Poll; O Ratmann; C Rokx; MS van Rooijen; MF Schim van der Loeff; WEM Schoute; GJ Sonder; J Veenstra; A Verbon; F Verdult; J de Vocht; HJ de Vries; S Vrouenraets; M van Vugt; WJ Wiersinga; FW Wit; LR Woittiez; S Zaheri; P Zantkuijl; MC van Zelm; A Żakowicz; HML Zimmermann
Keywords: acute HIV infection; men who have sex with men; same-day start; targeted testing; viral suppression
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Entry Date(s):
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Date Created: 20200506 Date Completed: 20210702 Latest Revision: 20210702
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Update Code:
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20240105
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DOI:
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10.1093/cid/ciaa505
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PMID:
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32369099
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Background: Men who have sex with men (MSM) with acute human immunodeficiency virus (HIV) infection (AHI) are a key source of new infections. To curb transmission, we implemented a strategy for rapid AHI diagnosis and immediate initiation of combination antiretroviral therapy (cART) in Amsterdam MSM. We assessed its effectiveness in diagnosing AHI and decreasing the time to viral suppression.
Methods: We included 63 278 HIV testing visits in 2008-2017, during which 1013 MSM were diagnosed. Standard of care (SOC) included HIV diagnosis confirmation in < 1 week and cART initiation in < 1 month. The AHI strategy comprised same-visit diagnosis confirmation and immediate cART. Time from diagnosis to viral suppression was assessed for 3 cART initiation periods: (1) 2008-2011: cART initiation if CD4 < 500 cells/μL (SOC); (2) January 2012-July 2015: cART initiation if CD4 < 500 cells/μL, or if AHI or early HIV infection (SOC); and (3a) August 2015-June 2017: universal cART initiation (SOC) or (3b) August 2015-June 2017 (the AHI strategy).
Results: Before implementation of the AHI strategy, the proportion of AHI among HIV diagnoses was 0.6% (5/876); after implementation this was 11.0% (15/137). Median time (in days) to viral suppression during periods 1, 2, 3a, and 3b was 584 (interquartile range [IQR], 267-1065), 230 (IQR, 132-480), 95 (IQR, 63-136), and 55 (IQR, 31-72), respectively (P < .001).
Conclusions: Implementing the AHI strategy was successful in diagnosing AHI and significantly decreasing the time between HIV diagnosis and viral suppression.
(© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America.)
