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Prompt linkage to care reduces HIV progression, time to viral suppression
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ATLANTA — HIV patients linked to care within 1 month achieved viral suppression quicker than those linked to care within 3 months, according to research data presented at the CDC’s National HIV Prevention Conference.
“One of the goals of the national strategy for the United States is to increase access to care and improve health outcomes for people living with HIV,” Anna Satcher Johnson, MPH, epidemiologist and supervisor at the HIV Incidence and Case Surveillance branch of the CDC’s Division of HIV/AIDS Prevention, said during a presentation. “A key strategy to achieve this goal is to ensure that people are linked to care as soon as they are diagnosed. Prompt linkage to care allows early initiation of ART, which is associated with reduced morbidity, mortality and transmission of the virus.”
Anna Satcher Johnson
Using data from the National HIV Surveillance System, Johnson and colleagues examined case information from 26,026 persons from 14 U.S. jurisdictions who received an HIV diagnosis in 2010 and 2011. They categorized patients based on the time between diagnosis and linkage to care (less than 1 month, 2 to 3 months, more than 3 months), and analyzed these groups for an association with the duration of illness before viral suppression. The researchers defined linkage of care as a patient’s first CD4 or viral load test result, and the major outcome was percentage of patients with viral suppression at 12 and 24 months.
According to Johnson and colleagues, 79% of enrolled patients were linked to care within 3 months, and 81.7% of those patients were linked to care within 1 month. The mean time to viral suppression for all patients diagnosed within 3 months was 15.9 months, with 63.6% and 75.5% achieving viral suppression at 12 months and 24 months, respectively. Compared with those linked to care within 1 month, a significantly lower proportion of patients linked to care within 2 to 3 months achieved viral suppression at 12 months (64.9% vs. 58.2%) and 24 months (76.1% vs. 72.7%). Outcomes were much worse for those who were not linked to care for more than 3 months, as viral suppression was only achieved by 17% at 12 months and 32.7% at 24 months.
“Raising the bar for prompt linkage to care supports current guidelines to offer treatment to all persons with HIV,” Johnson said. “Our results indicate that linkage within 1 month improves outcomes compared to linkage within 2 to 3 months, and may accelerate mitigation of onward HIV transmission.” – by Dave Muoio
Reference:
Hall HI, et al. Abstract 5057. Presented at: National HIV Prevention Conference; Dec. 6-9, 2015; Atlanta.
Disclosure: The researchers report no relevant financial disclosures.