Real world community-based HIV Rapid Start Antiretroviral with B/F/TAF versus prior models of antiretroviral therapy start - the RoCHaCHa study, a pilot study

AIDS Res Ther. 2024 Jul 10;21(1):45. doi: 10.1186/s12981-024-00631-6.

Abstract

Background: The rapid start of antiretroviral therapy (RSA) model initiates antiretroviral therapy (ART) as soon as possible after a new or preliminary diagnosis of HIV, in advance of HIV-1 RNA and other baseline laboratory testing. This observational study aims to determine if RSA with a single tablet regimen of bictegravir, emtricitabine, and tenofovir alafenamide (B/F/TAF) is an effective regimen for achieving viral suppression and accepted by patients at the time of diagnosis.

Methods: Adults newly or preliminarily diagnosed with HIV were enrolled from October 2018 through September 2021. Real world advantage, measured in days between clinical milestones and time to virologic suppression, associated with B/F/TAF RSA was compared to historical controls.

Results: All Study RSA participants (n = 45) accepted treatment at their first visit and 43(95.6%) achieved virologic suppression by week 48. Study RSA participants had a significantly shorter time (median 32 days) from diagnosis to ART initiation and virologic suppression, in comparison to historical controls (median 181 days) (n = 42). Qualitative feedback from study RSA participants showed high acceptance positive response to RSA.

Conclusions: RSA is feasible and well accepted by patients in a real-world community-based clinic setting. Promoting RSA in community-based clinics is an important tool in ending the HIV epidemic.

Keywords: ART; Community-based health care; HIV; HIV viral load suppression; Rapid start ART.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Alanine / therapeutic use
  • Amides / therapeutic use
  • Anti-HIV Agents* / therapeutic use
  • Emtricitabine* / administration & dosage
  • Emtricitabine* / therapeutic use
  • Female
  • HIV Infections* / drug therapy
  • HIV-1 / drug effects
  • Heterocyclic Compounds, 3-Ring / administration & dosage
  • Heterocyclic Compounds, 3-Ring / therapeutic use
  • Heterocyclic Compounds, 4 or More Rings / administration & dosage
  • Heterocyclic Compounds, 4 or More Rings / therapeutic use
  • Humans
  • Male
  • Middle Aged
  • Pilot Projects
  • Piperazines / therapeutic use
  • Pyridones
  • RNA, Viral / blood
  • Tenofovir* / administration & dosage
  • Tenofovir* / analogs & derivatives
  • Tenofovir* / therapeutic use
  • Viral Load / drug effects

Substances

  • Tenofovir
  • Anti-HIV Agents
  • Emtricitabine
  • bictegravir
  • Alanine
  • Heterocyclic Compounds, 3-Ring
  • Piperazines
  • Heterocyclic Compounds, 4 or More Rings
  • Amides
  • tenofovir alafenamide
  • RNA, Viral
  • Pyridones