Time from HIV diagnosis to commencement of antiretroviral therapy as an indicator to supplement the HIV cascade: Dramatic fall from 2011 to 2015

PloS One
Nicholas A MedlandChristopher K Fairley

Abstract

The HIV care cascade is increasingly used to evaluate HIV treatment programs at the population level. However, the cascade indicators lack the ability to show changes over time, which reduces their utility to guide health policy. Alternatives have been proposed but are complex or result in a delay in results. We propose a new indicator of ART uptake, the time from HIV diagnosis to commencement of ART, and compare it to the existing cascade indicator of proportion of patients on treatment and the WHO proposed cohort cascade indicator of proportion of patients on treatment within one year of diagnosis. Records from patients from the two largest HIV treatment centres in the state of Victoria, Australia (Melbourne Sexual Health Centre and The Alfred Hospital Department of Infectious Diseases) from 2011 to 2015 were extracted. The intervals between date of diagnosis, entry into care and initiation of ART were compared. From 2011 to 2015 the proportion of in-care patients who were on ART rose from 87% to 93% (p<0.0001). From 2011 to 2014, the proportion of patients in care and on ART within one year of diagnosis increased from 43.4% to 78.9% (p = 0.001). The median time from diagnosis to ART fell from 418 days (IQR: 91-1176) to 77 da...Continue Reading

References

Nov 16, 2001·Revista Panamericana De Salud Pública = Pan American Journal of Public Health·UNKNOWN Panel on Clinical Practices for Treatment of HIV infection
Mar 4, 2011·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Edward M GardnerWilliam J Burman
Jul 20, 2011·The New England Journal of Medicine·Myron S CohenUNKNOWN HPTN 052 Study Team
Mar 12, 2015·The Medical Journal of Australia·Limin MaoJohn B F de Wit
May 27, 2015·PloS One·James H McMahonUNKNOWN Victorian Initiative for Patient Engagement and Retention VIPER Study Group
Jul 21, 2015·The New England Journal of Medicine·UNKNOWN INSIGHT START Study GroupJames D Neaton
Jul 21, 2015·The New England Journal of Medicine·UNKNOWN TEMPRANO ANRS 12136 Study GroupXavier Anglaret
Dec 3, 2015·Journal of the International AIDS Society·Nicholas A MedlandChristopher K Fairley
Dec 10, 2015·Sexually Transmitted Diseases·Katelynne Gardner TorenMatthew R Golden

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Citations

Apr 1, 2019·The Medical Journal of Australia·Kasha P Singh, Sharon R Lewin
Apr 16, 2019·Journal of the International AIDS Society·Benjamin R BavintonUNKNOWN Opposites Attract Study Group
Oct 29, 2020·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Ravi GoyalBoyd Gilman
May 20, 2021·Scientific Reports·Nikolina BogdanićJosip Begovac
Sep 15, 2018·The Lancet. HIV·Eric P F ChowChristopher K Fairley

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