Time from HIV Diagnosis to Viral Load Suppression: 2007-2013
BACKGROUND:
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.
METHODS:
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.
RESULTS:
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.
CONCLUSIONS:
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.
- 1From the *Public Health-Seattle & King County HIV/STD Program, Seattle, WA; Departments of †Epidemiology and ‡Medicine, University of Washington, Seattle, WA; and §Department of Geography, University of California Santa Barbara, Santa Barbara, CA.
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