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.

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., Antinori, 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., Antinori, A., Castagna, A., Ceccherini-silberstein, F., Cozzi-lepri, A., Girardi, E., Lo Caputo, S., Mussini, C., Puoti, M., Perno, C. F., Antinori, A., 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., Puoti, M., 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., Puoti, M., 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., Antinori, A., 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., Virological response and retention in care according to time of starting ART in Italy: Data from the Icona Foundation Study cohort, <<JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY>>, 2020; 75 (3): 681-689. [doi:10.1093/jac/dkz512] [http://hdl.handle.net/10807/153456]

Virological response and retention in care according to time of starting ART in Italy: Data from the Icona Foundation Study cohort

Cauda, R.;Cingolani, A.;Segala, D.;Cauda, R.;Moschese, D.;Cingolani, A.;
2020

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.
Inglese
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., Antinori, 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., Antinori, A., Castagna, A., Ceccherini-silberstein, F., Cozzi-lepri, A., Girardi, E., Lo Caputo, S., Mussini, C., Puoti, M., Perno, C. F., Antinori, A., 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., Puoti, M., 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., Puoti, M., 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., Antinori, A., 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., Virological response and retention in care according to time of starting ART in Italy: Data from the Icona Foundation Study cohort, <<JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY>>, 2020; 75 (3): 681-689. [doi:10.1093/jac/dkz512] [http://hdl.handle.net/10807/153456]
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