Impact of the implementation of early initiation of antiretroviral therapy in new HIV diagnoses: case-control study

Abstract

In Honduras, priority is still given to ensuring acceptance of HIV diagnosis and adherence to ART treatment, causing delay in its initiation, negative consequences, and high risk of death. Objective: To evaluate the impact of early ART initiation in patients with new HIV diagnoses at the Mario Catarino Rivas National Hospital (HNMCR). Patients and Methods: Analytical, observational, case-control research. Sample of 62 cases who initiated ART early, from January to August 2019 at HNMCR and 62 controls who initiated ART in 2018, outside the early initiation strategy. Data were taken from clinical records and information was vacuumed from surveys. Results: We found faster service linkage and more early ART initiations in the case group (OR 19.6, 95% CI 7.2- 53.0, p=0.000), higher early-stage A1 uptake (OR 3.45, 95% CI 1.36-8.59, p=0.006), lower clinical stage change (OR 2.35, 95% CI 0. 92-5.98, p= 0.070), higher compliance with psychological evaluation (OR 8.15, 95% CI 3.42-19.4, p=0.000), lower risk of opportunistic infections (OR 3.01, 95% CI 1.34-6.74, p=0.006), lower risk of hospitalization (OR 1.33, 95% CI 0.46-3.84, p=0.596), higher OI screening (p=0.000). Conclusions/Recommendation: The initiation of ART in the first 7 days after diagnosis provides clinical and prophylactic benefits, improving the quality of life and decreasing the transmissibility of the virus. It is recommended to protocolize early initiation as a strategy for new HIV diagnoses.