Time From HIV Diagnosis to Viral Load Suppression: 2007-2013.
Time From HIV Diagnosis to Viral Load Suppression: 2007-2013.
复制标题
DOI：
10.1097/olq.0000000000000376
复制
发表时间：
2016-01
影响因子：
3.1
通讯作者：
Golden MR
中科院分区：
文献类型：
--
作者：
Toren KG;Buskin SE;Dombrowski JC;Cassels SL;Golden MR
美国指南现在建议所有艾滋病毒感染者接受抗逆转录病毒治疗)。艾滋病毒预防日益侧重于确保感染者在感染艾滋病毒后不久得到诊断，并迅速与护理和启动抗逆转录病毒治疗联系起来。我们检查了华盛顿州金县从艾滋病毒诊断到病毒载量抑制的时间趋势，以衡量随着时间的推移我们艾滋病毒护理连续体系的改善。我们使用HIV监测数据和COX比例风险来评估2007至2013年间华盛顿州金县新诊断为HIV感染者的从诊断到病毒抑制的时间是如何变化的。在1766名新确诊患者中，共有1490人(84%)在213天的中位时间内实现了病毒抑制(95%可信区间203-229)。在2007年和2013年确诊的所有患者中，有36%和77%的人在艾滋病毒确诊后12个月内被病毒抑制(P<；0.0001)。当按诊断时的CD4计数分层时，按日历年进行抑制的时间差异仍然存在。RACE与病毒抑制的时间没有显著关联。从艾滋病毒诊断到病毒抑制的时间在2007至2013年间大幅下降，华盛顿州金县最近确诊的艾滋病毒感染者中，超过四分之三现在在诊断后一年内实现了病毒抑制。这一改善在所有新诊断为艾滋病毒携带者中都很明显，无论种族/民族或诊断时的CD4计数。
US guidelines now recommend that all HIV-infected persons receive antiretroviral therapy). HIV prevention is increasingly focused on ensuring that infected persons are diagnosed soon after HIV acquisition and quickly link to care and initiate antiretroviral therapy. We examined trends in time from HIV diagnosis to viral load suppression in King County, WA, to gauge improvement in our HIV care continuum over time. We used HIV surveillance data and Cox proportional hazards to evaluate how the time from diagnosis to viral suppression changed among persons newly diagnosed as having HIV in King County, WA, between 2007 and 2013. A total of 1490 (84%) of 1766 newly diagnosed persons achieved viral suppression in a median time of 213 days (95% confidence interval, 203–229). Thirty-six percent of all persons diagnosed in 2007 and 77% in 2013 were virally suppressed within 12 months of HIV diagnosis (P < 0.0001). Differences in time to suppression by calendar year persisted when stratifying by CD4 count at diagnosis. Race was not significantly associated with time to viral suppression. Time from HIV diagnosis to viral suppression dramatically declined between 2007 and 2013, and more than three quarters of recently HIV-diagnosed individuals in King County, WA, now achieve viral suppression within a year of diagnosis. This improvement was evident among all persons newly diagnosed as having HIV, regardless of race/ethnicity or CD4 count at time of diagnosis.