engleski

Antiretroviral therapy initiation at entry into HIV care, Croatia, 2015-2020

Background: In Croatia, persons living with HIV (PLWH) are treated and supplied with antiretroviral therapy (ART) only at the University Hospital for Infectious Diseases, Zagreb. Since about 55% of PLWH are not from Zagreb, we introduced ART on the first day of entry into care. We examined the frequency, virologic outcome, and factors related to same-day ART initiation from 2015-2020. Methods: Included were Croatian citizens/permanent residents ≥16 years old. Same-day ART was defined as ART initiation at the date of entry into care or the next day (Days 0 & 1). Multivariable logistic regression was done to assess factors related to same-day ART. We measured time from ART initiation to HIV-1 RNA < 50 copies/ml by Kaplan- Meier estimates. Results: Of 540 persons who entered HIV care, 530 started ART. Same-day ART was present in 348/530 (65.7%)(Table). Median time to ART initiation from HIV diagnosis was 8.0 days, rapid ART (within 7-days of HIV diagnosis) was initiated in 264/530 (48.9%). Of 348 same-day ART starters, 211 (60.6%) initiated ART within 7-days of HIV diagnosis. Same-day and rapid ART initiation was more frequent in 2018-2020 vs. 2015-2017 and increased from 2015 to 2020. Persons with no clinical AIDS were more likely to start same-day ART vs. those with clinical AIDS as were those living outside Zagreb. Same-day ART resulted in earlier viral suppression. Conclusions: Same-day ART became more frequent in recent years, it was associated with not having clinical AIDS and living outside Zagreb, and had a favorable virologic outcome.

Antiretroviral therapy ; HIV ; care ; Croatia

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