Evaluation of rapid antiretroviral initiation strategy in a cohort of newly diagnosed people living with HIV in Panama, 2018-2019

AIDS Care. 2024 Nov;36(11):1588-1595. doi: 10.1080/09540121.2024.2373397. Epub 2024 Jul 11.

Abstract

Antiretroviral therapy (ART) has been adopted as a form of HIV treatment and prevention. This study assesses rapid ART initiation using clinical outcomes such as viral load (VL) and CD4+ T lymphocytes count. Over the course of one year, the progress of newly diagnosed people living with HIV who started ART early in a hospital in Panama City was followed. The evaluation of early initiation of ART in achieving viral suppression (VL <200 copies/ml) was analyzed using descriptive statistics. Additionally, the cost difference between early (first 7 days) and late initiation of ART was evaluated from the perspective of the service provider. In total, 209 people were followed up during the study; 85% were male, 70% started ART on same day from hospital arrival, 80% had suppressed viral load at 6 months, and the median count of CD4 increased from 285 (IQR: 166-429) to 509 (IQR: 373-696) over 12 months. Starting ART early led to a 42% increase for the provider in terms of staffing costs; however, the clients had the opportunity to decrease absenteeism in daily activities. The results reveal that early initiation of ART generates clinical and economic benefits for the person in treatment.

Keywords: HIV; Healthcare and well-being; antiretroviral therapy; early initiation; partnerships for the goals; reduced inequalities.

MeSH terms

  • Adult
  • Anti-HIV Agents* / therapeutic use
  • CD4 Lymphocyte Count
  • Female
  • HIV Infections* / drug therapy
  • Humans
  • Male
  • Middle Aged
  • Panama / epidemiology
  • Time-to-Treatment / statistics & numerical data
  • Treatment Outcome
  • Viral Load*

Substances

  • Anti-HIV Agents