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.
Virological response and retention in care according to time of starting ART in Italy: Data from the Icona Foundation Study cohort / D'Arminio Monforte, A.; Tavelli, A.; Cozzi-Lepri, A.; Castagna, A.; Passerini, S.; Francisci, D.; Saracino, A.; Maggiolo, F.; Lapadula, G.; Girardi, E.; Perno, C. F.; Antinori, A.; D'Arminio Monforte, A.; Andreoni, M.; Castagna, A.; Castelli, F.; Cauda, R.; Di Perri, G.; Galli, M.; Iardino, R.; Ippolito, G.; Lazzarin, A.; Marchetti, G. C.; Rezza, G.; Von Schloesser, F.; Viale, P.; D'Arminio Monforte, A.; Castagna, A.; Ceccherini-Silberstein, F.; Cozzi-Lepri, A.; Girardi, E.; Lo Caputo, S.; Mussini, C.; Puoti, M.; Perno, C. F.; Bai, F.; Balotta, C.; Bandera, A.; Bonora, S.; Borderi, M.; Calcagno, A.; Capetti, A.; Capobianchi, M. R.; Castagna, A.; Ceccherini-Silberstein, F.; Cicalini, S.; Cingolani, A.; Cinque, P.; Cozzi-Lepri, A.; D'Arminio Monforte, A.; De Luca, A.; Di Biagio, A.; Girardi, E.; Gianotti, N.; Gori, A.; Guaraldi, G.; Lapadula, G.; Lichtner, M.; Lo Caputo, S.; Madeddu, G.; Maggiolo, F.; Marchetti, G.; Monno, L.; Mussini, C.; Nozza, S.; Perno, C. F.; Pinnetti, C.; Quiros Roldan, E.; Rossotti, R.; Rusconi, S.; Santoro, M. M.; Saracino, A.; Sarmati, L.; Cozzi-Lepri, A.; Fanti, I.; Galli, L.; Lorenzini, P.; Rodano, A.; Macchia, M.; Tavelli, A.; Carletti, F.; Carrara, S.; Di Caro, A.; Graziano, S.; Petroni, F.; Prota, G.; Truffa, S.; Giacometti, A.; Costantini, A.; Barocci, V.; Angarano, G.; Monno, L.; Milano, E.; Maggiolo, F.; Suardi, C.; Viale, P.; Donati, V.; Verucchi, G.; Castelnuovo, F.; Minardi, C.; Quiros Roldan, E.; Menzaghi, B.; Abeli, C.; Cacopardo, B.; Celesia, B.; Vecchiet, J.; Falasca, K.; Pan, A.; Lorenzotti, S.; Sighinolfi, L.; Segala, D.; Blanc, P.; Vichi, F.; Cassola, G.; Viscoli, C.; Alessandrini, A.; Bobbio, N.; Mazzarello, G.; Lichtner, M.; Fondaco, L.; Bonfanti, P.; Molteni, C.; Chiodera, A.; Milini, P.; Nunnari, G.; Pellicano, G.; D'Arminio Monforte, A.; Galli, M.; Lazzarin, A.; Rizzardini, G.; Castagna, A.; Cannizzo, E. S.; Moioli, M. C.; Piolini, R.; Bernacchia, D.; Salpietro, S.; Tincati, C.; Mussini, C.; Puzzolante, C.; Migliorino, C.; Lapadula, G.; Sangiovanni, V.; Borgia, G.; Esposito, V.; Di Flumeri, G.; Gentile, I.; Rizzo, V.; Cattelan, A. M.; Marinello, S.; Cascio, A.; Trizzino, M.; Francisci, D.; Schiaroli, E.; Parruti, G.; Sozio, F.; Magnani, G.; Ursitti, M. A.; Andreoni, M.; Cauda, R.; Cristaudo, A.; Vullo, V.; Acinapura, R.; Moschese, D.; Capozzi, M.; Mondi, A.; Cingolani, A.; Rivano Capparuccia, M.; Iaiani, G.; Latini, A.; Gagliardini, R.; Plazzi, M. M.; De Girolamo, G.; Vergori, A.; Cecchetto, M.; Viviani, F.; Madeddu, G.; De Vito, A.; Rossetti, B.; Montagnani, F.; Franco, A.; Fontana Del Vecchio, R.; Di Giuli, C.; Caramello, P.; Di Perri, G.; Bonora, S.; Orofino, G. C.; Sciandra, M.; Bassetti, M.; Londero, A.; Manfrin, V.; Battagin, G.; Starnini, G.; Ialungo, A.. - In: JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY. - ISSN 0305-7453. - 75:3(2020), pp. 681-689. [10.1093/jac/dkz512]
Virological response and retention in care according to time of starting ART in Italy: Data from the Icona Foundation Study cohort
Castagna A.;Castagna A.;Galli M.;Lazzarin A.;Rezza G.;Castagna A.;Castagna A.;Costantini A.;Galli M.;Lazzarin A.;Castagna A.;
2020-01-01
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.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
