Trends in time from HIV diagnosis to first viral suppression following revised U.S. HIV treatment guidelines, 2012–2017

Details

• Alternative Title:
  J Acquir Immune Defic Syndr
• Personal Author:
  Crepaz, Nicole ; Song, Ruiguang ; Lyss, Sheryl ; Hall, H. Irene
• Description:
  Background:
  
  Since 2012, treatment guidelines have recommended initiating antiretroviral therapy for all persons as soon as possible after HIV diagnosis, irrespective of CD4 counts. If clinicians adopted the treatment guidelines, a shortened interval between diagnosis and first viral suppression (Dx-to-VS) would be expected, with greater declines among those with CD4 counts ≥500 cells/μL at diagnosis.
  
  Methods:
  
  Using the National HIV Surveillance System data, we examined Dx-to-VS intervals among persons aged ≥13 years with HIV infection diagnosed during 2012–2017. Analyses were stratified by the first CD4 count: CD4 ≥500 cells/μL, 200–499 cells/μL, <200 cells/μL, and no CD4 value reported within 3 months after diagnosis.
  
  Results:
  
  During 2012–2017 in the 27 US jurisdictions with complete laboratory reporting, 138,759 HIV diagnoses occurred. The median Dx-to-VS interval shortened overall for persons with HIV diagnosed in 2012 vs. 2017 from 9 to 5 months, a 12.3% annual decrease (P < 0.001) and in all CD4 groups. In 2012, the Dx-to-VS interval was longer for persons with CD4 ≥500 cells/μL than 200–499 cells/μL and <200 cells/μL (median, 9, 7, and 6 months, respectively). By 2017, the median interval was 4 months for these groups, compared with 25 months for those without a CD4 value within 3 months after diagnosis.
  
  Conclusion:
  
  Decreases in Dx-to-VS intervals across all CD4 groups with a greater decrease among those with CD4 ≥500 cells/μL are consistent with the implementation of treatment recommendations. The Dx-to-VS interval was longest among persons not linked to care within 3 months after diagnosis, underscoring the importance of addressing barriers to linkage to care for ending the HIV epidemic.
  
  
• Subjects:
  Adolescent Adult Anti-HIV Agents Article CD4 Lymphocyte Count Drug Administration Schedule Female HIV-1 HIV Infections HIV Treatment Guidelines Humans Male Middle Aged Persons With Diagnosed HIV Infection Time Factors Time From Diagnosis To Viral Suppression United States Viral Load Young Adult

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• Source:
  J Acquir Immune Defic Syndr. 85(1):46-50
• Pubmed ID:
  32379083
• Pubmed Central ID:
  PMC9647153
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Volume:
  85
• Issue:
  1
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:41ab214a608b2f0db2c806a6836cf1f7952d9e2cff13a6993cc373437cf750a2
• Download URL:
  https://stacks.cdc.gov/view/cdc/122195/cdc_122195_DS1.pdf
• File Type:
  [PDF - 72.92 KB ]