Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, USA.
Institute of HIV Research and Innovation, Bangkok, Thailand.
J Int AIDS Soc. 2021 Dec;24(12):e25869. doi: 10.1002/jia2.25869.
WHO has recommended rapid antiretroviral therapy (ART) initiation, including same-day ART (SDART). However, data on the feasibility in real-world settings are limited. We implemented a cohort study at a stand-alone HIV testing centre to examine its applicability and effectiveness.
Data were collected from the Thai Red Cross Anonymous Clinic in Bangkok, Thailand, between July 2017 and July 2018 from clients who were ART-naïve and could return for follow-up visits. Baseline laboratory tests and chest X-ray were performed according to national guidelines, and clinical eligibility was determined based on physical examination and chest X-ray findings. Primary outcomes were retention in care and viral load suppression at 3, 6 and 12 months.
During the study period, 2427 people tested HIV positive. Of these, 2107 (2207/2427, 86.8%) met logistical criteria, and 1904 (1904/2427, 78.5%) agreed to SDART. One thousand seven hundred and twenty-nine (1729/2427, 71.2%) were placed on ART, with 1257 received same-day initiation and 1576 initiated ART within 7 days; 1198 clients were successfully referred to free, sustained ART sites. Retention among eligible clients who accepted SDART service at months 3, 6 and 12 was 79.8%, 75.2% and 75.3%, respectively.
Same-day ART initiation hub model at a stand-alone HIV testing centre in an urban setting in Bangkok, Thailand, is highly feasible and has a potential for scaling up.
NCT04032028.
世界卫生组织（WHO）推荐快速抗逆转录病毒治疗（ART）的启动，包括当天开始 ART（SDART）。然而，在实际环境中的可行性数据有限。我们在一个独立的艾滋病毒检测中心实施了一项队列研究，以检验其适用性和有效性。
数据来自于 2017 年 7 月至 2018 年 7 月在泰国曼谷的泰国红十字会匿名诊所的 ART 初治且能够进行随访的客户。根据国家指南进行基线实验室检查和胸部 X 光检查，并根据体检和胸部 X 光检查结果确定临床适宜性。主要结局是 3、6 和 12 个月时的保留在治疗中以及病毒载量抑制情况。
在研究期间，共有 2427 人 HIV 检测呈阳性。其中，2107 人（2207/2427，86.8%）符合物流标准，1904 人（1904/2427，78.5%）同意接受 SDART。1729 人（1729/2427，71.2%）开始接受 ART，其中 1257 人当天开始，1576 人在 7 天内开始；1198 名患者被成功转介到免费、持续的 ART 场所。接受 SDART 服务的合格患者在第 3、6 和 12 个月时的保留率分别为 79.8%、75.2%和 75.3%。
在曼谷的一个城市独立艾滋病毒检测中心，当天开始 ART 的启动模式具有高度可行性，并且具有扩大规模的潜力。
NCT04032028。
