Same-day antiretroviral therapy initiation for HIV-infected adults in South Africa: Analysis of routine data

English version

Autoři: Rivka R. Lilian ^aff001; Kate Rees ^aff001; James A. McIntyre ^aff001; Helen E. Struthers ^aff001; Remco P. H. Peters ^aff001
Působiště autorů: Anova Health Institute, Johannesburg, South Africa ^aff001; School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa ^aff002; Division of Infectious Diseases & HIV Medicine, Department of Medicine, University of Cape Town, Cape Town, South Africa ^aff003; School of Public Health, University of the Witwatersrand, Johannesburg, South Africa ^aff004; Department of Medical Microbiology, School of Public Health & Primary Care (CAPHRI), Maastricht University Medical Centre, Maastricht, The Netherlands ^aff005
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0227572

Souhrn

Same-day initiation (SDI) of antiretroviral therapy (ART) has been recommended to improve ART programme outcomes in South Africa since August 2017. This study assessed implementation of SDI over time in two South African districts, describing the characteristics of same-day initiators and evaluating the impact of SDI on retention in ART care. Routine data were analysed for HIV-infected adults who were newly initiating ART in Johannesburg or Mopani Districts between October 2017 and June 2018. Characteristics of same-day ART initiators were compared to later initiators, and losses to follow-up (LTFU) to six months were assessed using Kaplan Meier survival analysis and multivariate logistic regression. The dataset comprised 32 290 records (29 964 from Johannesburg and 2 326 from Mopani). The overall rate of SDI was 40.4% (n = 13 038), increasing from 30.3% in October 2017 to 54.2% in June 2018. Same-day ART initiators were younger, more likely to be female and presented with less advanced clinical disease than those initiating treatment at later times following diagnosis (p<0.001 for all). SDI was associated with disengagement from care: LTFU was 30.1% in the SDI group compared to 22.4%, 19.8% and 21.9% among clients initiating ART 1–7 days, 8–21 days and ≥22 days after HIV diagnosis, respectively (p<0.001). LTFU was significantly more likely among clients in Johannesburg versus Mopani (adjusted odds ratio (aOR) = 1.43, p<0.001) and among same-day versus later initiators (aOR = 1.45, p<0.001), while increasing age reduced LTFU (aOR = 0.97, p<0.001). In conclusion, SDI has increased over time as per national guidelines, but there is serious concern regarding the reduced rate of retention among same-day initiators. Nevertheless, SDI may result in a net programmatic benefit provided that interventions are implemented to support client readiness for treatment and ongoing engagement in ART care, particularly among younger adults in large ART programmes such as Johannesburg.

Klíčová slova:

Antiretroviral therapy – Global health – HIV – HIV diagnosis and management – Pregnancy – Public and occupational health – South Africa – Survival analysis

Zdroje

1. Johnson LF, Dorrington RE. Thembisa model 4.1 national and provincial model outputs. 2018 [cited 2019 Jun 07]. https://thembisa.org/content/downloadPage/ProvOutput4_1.

2. World Health Organization. South Africa—HIV country profile: 2017. Geneva: WHO; 2019 [cited 2019 May 30]. http://cfs.hivci.org/country-factsheet.html.

3. National Department of Health of South Africa. National antiretroviral treatment guidelines. Pretoria: NDoH; 2004.

4. South African Government. Statement on the meeting of the South African National AIDS Council. Pretoria: SANAC; 2011 [cited 2019 Jun 21]. https://www.gov.za/statement-meeting-south-african-national-aids-council-sanac.

5. National Department of Health of South Africa. National consolidated guidelines for the prevention of mother-to-child transmission of HIV (PMTCT) and the management of HIV in children, adolescents and adults. Pretoria: NDoH; December 2014.

6. Johnson LF, Dorrington RE, Moolla H. Progress towards the 2020 targets for HIV diagnosis and antiretroviral treatment in South Africa. South Afr J HIV Med. 2017; 18(1): 694. https://doi.org/10.4102/sajhivmed.v18i1.694 29568630

7. National Department of Health of South Africa. Implementation of the universal test and treat strategy for HIV positive patients and differentiated care for stable patients (Circular). Pretoria: NDoH; 2016.

8. Bor J, Chiu C, Ahmed S, Katz I, Fox MP, Rosen S, et al. Failure to initiate HIV treatment in patients with high CD4 counts: evidence from demographic surveillance in rural South Africa. Trop Med Int Health. 2018; 23(2): 206–220. https://doi.org/10.1111/tmi.13013 29160949

9. Katz IT, Dietrich J, Tshabalala G, Essien T, Rough K, Wright AA, et al. Understanding treatment refusal among adults presenting for HIV-testing in Soweto, South Africa: a qualitative study. AIDS Behav. 2015; 19(4): 704–714. https://doi.org/10.1007/s10461-014-0920-y 25304330

10. Govindasamy D, Ford N, Kranzer K. Risk factors, barriers and facilitators for linkage to antiretroviral therapy care: a systematic review. AIDS. 2012; 26(16): 2059–2067. https://doi.org/10.1097/QAD.0b013e3283578b9b 22781227

11. MacPherson P, MacPherson EE, Mwale D, Bertel Squire S, Makombe SD, Corbett EL, et al. Barriers and facilitators to linkage to ART in primary care: a qualitative study of patients and providers in Blantyre, Malawi. J Int AIDS Soc. 2012; 15(2): 18020. https://doi.org/10.7448/IAS.15.2.18020 23336700

12. National Department of Health of South Africa. Fast tracking implementation of the 90-90-90 strategy for HIV, through implementatin of the universal test and treat (UTT) and same day antiretroviral therapy (ART) initiation for HIV positive patients (Circular). Pretoria: NDoH; 4 August 2017.

13. Meintjes G, Moorhouse MA, Carmona S, Davies N, Dlamini S, van Vuuren C, et al. Adult antiretroviral therapy guidelines 2017. South Afr J HIV Med. 2017; 18(1): 776. https://doi.org/10.4102/sajhivmed.v18i1.776 29568644

14. Mugglin C, Estill J, Wandeler G, Bender N, Egger M, Gsponer T, et al. Loss to programme between HIV diagnosis and initiation of antiretroviral therapy in sub-Saharan Africa: systematic review and meta-analysis. Trop Med Int Health. 2012; 17(12): 1509–1520. https://doi.org/10.1111/j.1365-3156.2012.03089.x 22994151

15. Togun T, Peterson I, Jaffar S, Oko F, Okomo U, Peterson K, et al. Pre-treatment mortality and loss-to-follow-up in HIV-1, HIV-2 and HIV-1/HIV-2 dually infected patients eligible for antiretroviral therapy in The Gambia, West Africa. AIDS Res Ther. 2011; 8(1): 24. https://doi.org/10.1186/1742-6405-8-24 21774813

16. Amanyire G, Semitala FC, Namusobya J, Katuramu R, Kampiire L, Wallenta J, et al. Effects of a multicomponent intervention to streamline initiation of antiretroviral therapy in Africa: a stepped-wedge cluster-randomised trial. Lancet HIV. 2016; 3(11): e539–e548. https://doi.org/10.1016/S2352-3018(16)30090-X 27658873

17. Koenig SP, Dorvil N, Devieux JG, Hedt-Gauthier BL, Riviere C, Faustin M, et al. Same-day HIV testing with initiation of antiretroviral therapy versus standard care for persons living with HIV: A randomized unblinded trial. PLoS Med. 2017; 14(7): e1002357. https://doi.org/10.1371/journal.pmed.1002357 28742880

18. Labhardt ND, Ringera I, Lejone TI, Klimkait T, Muhairwe J, Amstutz A, et al. Effect of offering same-day ART vs usual health facility referral during home-based HIV testing on linkage to care and viral suppression among adults with HIV in Lesotho: the CASCADE randomized clinical trial. JAMA. 2018; 319(11): 1103–1112. https://doi.org/10.1001/jama.2018.1818 29509839

19. Rosen S, Maskew M, Fox MP, Nyoni C, Mongwenyana C, Malete G, et al. Initiating antiretroviral therapy for HIV at a patient’s first clinic visit: the RapIT randomized controlled trial. PLoS Med. 2016; 13(5): e1002015. https://doi.org/10.1371/journal.pmed.1002015 27163694

20. Geng EH, Havlir DV. The science of rapid start—from the when to the how of antiretroviral initiation. PLoS Med. 2017; 14(7): e1002358. https://doi.org/10.1371/journal.pmed.1002358 28742819

21. Chan AK, Kanike E, Bedell R, Mayuni I, Manyera R, Mlotha W, et al. Same day HIV diagnosis and antiretroviral therapy initiation affects retention in Option B+ prevention of mother-to-child transmission services at antenatal care in Zomba District, Malawi. J Int AIDS Soc. 2016; 19(1): 20672. https://doi.org/10.7448/IAS.19.1.20672 26976377

22. Langwenya N, Phillips TK, Brittain K, Zerbe A, Abrams EJ, Myer L. Same-day antiretroviral therapy (ART) initiation in pregnancy is not associated with viral suppression or engagement in care: A cohort study. J Int AIDS Soc. 2018; 21(6): e25133. https://doi.org/10.1002/jia2.25133 29939483

23. Tenthani L, Haas AD, Tweya H, Jahn A, van Oosterhout JJ, Chimbwandira F, et al. Retention in care under universal antiretroviral therapy for HIV-infected pregnant and breastfeeding women (‘Option B+’) in Malawi. AIDS. 2014; 28(4): 589–598. https://doi.org/10.1097/QAD.0000000000000143 24468999

24. Black S, Zulliger R, Myer L, Marcus R, Jeneker S, Taliep R, et al. Safety, feasibility and efficacy of a rapid ART initiation in pregnancy pilot programme in Cape Town, South Africa. S Afr Med J. 2013; 103(8): 557–562. https://doi.org/10.7196/samj.6565 23885739

25. Rufu A, Chitimbire VTS, Nzou C, Timire C, Owiti P, Harries AD, et al. Implementation of the ‘Test and Treat’ policy for newly diagnosed people living with HIV in Zimbabwe in 2017. Public Health Action. 2018; 8(3): 145–150. https://doi.org/10.5588/pha.18.0030 30271732

26. MacKellar D, Williams D, Bhembe B, Dlamini M, Byrd J, Dube L, et al. Peer-delivered linkage case management and same-day ART initiation for men and young persons with HIV infection—Eswatini, 2015–2017. MMWR Morb Mortal Wkly Rep. 2018; 67(23): 663–667. https://doi.org/10.15585/mmwr.mm6723a3 29902168

27. Wilkinson L, Duvivier H, Patten G, Solomon S, Mdani L, Patel S, et al. Outcomes from the implementation of a counselling model supporting rapid antiretroviral treatment initiation in a primary healthcare clinic in Khayelitsha, South Africa. South Afr J HIV Med. 2015; 16(1): 367. https://doi.org/10.4102/sajhivmed.v16i1.367 29568589

28. Osler M, Hilderbrand K, Hennessey C, Arendse J, Goemaere E, Ford N, et al. A three-tier framework for monitoring antiretroviral therapy in high HIV burden settings. J Int AIDS Soc. 2014; 17: 18908. https://doi.org/10.7448/IAS.17.1.18908 24780511

29. Massyn N, Pillay Y, Padarath A, editors. District Health Barometer 2017/18. Durban: Health Systems Trust; January 2019.

30. National Department of Health of South Africa. The 2015 national antenatal sentinel HIV & syphilis survey. Pretoria: NDoH; 2017.

31. Stata Corp LLC. sts test—test equality of survivor functions. Texas: Stata; 2019 [cited 2019 May 23]. https://www.stata.com/manuals13/stststest.pdf.

32. Pilcher CD, Ospina-Norvell C, Dasgupta A, Jones D, Hartogensis W, Torres S, et al. The effect of same-day observed initiation of antiretroviral therapy on HIV viral load and treatment outcomes in a US public health setting. J Acquir Immune Defic Syndr. 2017; 74(1): 44–51. https://doi.org/10.1097/QAI.0000000000001134 27434707

33. Hoenigl M, Chaillon A, Moore DJ, Morris SR, Mehta SR, Gianella S, et al. Rapid HIV viral load suppression in those initiating antiretroviral therapy at first visit after HIV diagnosis. Sci Rep. 2016; 6: 32947. https://doi.org/10.1038/srep32947 27597312

34. Fomundam HN, Tesfay AR, Mushipe SA, Mosina MB, Boshielo CT, Nyambi HT, et al. Prevalence and predictors of late presentation for HIV care in South Africa. S Afr Med J. 2017; 107(12): 1058–1064. https://doi.org/10.7196/SAMJ.2017.v107i12.12358 29262956

35. Lilian RR, Rees K, Mabitsi M, McIntyre JA, Struthers HE, Peters RPHP. Baseline CD4 and mortality trends in the South African human immunodeficiency virus programme: analysis of routine data. S Afr J HIV Med. 2019; 20(1): a963. https://doi.org/10.4102/sajhivmed.v20i1.963

36. Hoffman S, Wu Y, Lahuerta M, Kulkarni SG, Nuwagaba-Biribonwoha H, Sadr WE, et al. Advanced disease at enrollment in HIV care in four sub-Saharan African countries: change from 2006 to 2011 and multilevel predictors in 2011. AIDS. 2014; 28(16): 2429–2438. https://doi.org/10.1097/QAD.0000000000000427 25136842

37. Kerschberger B, Mazibuko S, Zabsonre I, Teck R, Kabore S, Etoori D, et al. 6-months treatment outcomes of patients initiating ART under the WHO test & treat approach. 21st International AIDS Conference; 18–22 July 2016; Durban, South Africa.

38. Stevens WS, Gous NM, MacLeod WB, Long LC, Variava E, Martinson NA, et al. Multidisciplinary point-of-care testing in South African primary health care clinics accelerates HIV ART initiation but does not alter retention in care. J Acquir Immune Defic Syndr. 2017; 76(1): 65–73. https://doi.org/10.1097/QAI.0000000000001456 28542080

39. Ankomah A, Ganle JK, Lartey MY, Kwara A, Nortey PA, Okyerefo MP, et al. ART access-related barriers faced by HIV-positive persons linked to care in southern Ghana: a mixed method study. BMC Infect Dis. 2016; 16(1): 738. https://doi.org/10.1186/s12879-016-2075-0 27927183

40. Fox MP, Rosen S, Geldsetzer P, Barnighausen T, Negussie E, Beanland R. Interventions to improve the rate or timing of initiation of antiretroviral therapy for HIV in sub-Saharan Africa: meta-analyses of effectiveness. J Int AIDS Soc. 2016; 19(1): 20888. https://doi.org/10.7448/IAS.19.1.20888 27507249

41. World Health Organization. Guidelines for managing advanced HIV disease and rapid initiation of antiretroviral therapy. Geneva: WHO; 2017.

42. Kerschberger B, Schomaker M, Ciglenecki I, Pasipamire L, Mabhena E, Telnov A, et al. Programmatic outcomes and impact of rapid public sector antiretroviral therapy expansion in adults prior to introduction of the WHO treat-all approach in rural Eswatini. Trop Med Int Health. 2019; 24(6): 701–714. https://doi.org/10.1111/tmi.13234 30938037

43. Tweya H, Oboho IK, Gugsa ST, Phiri S, Rambiki E, Banda R, et al. Loss to follow-up before and after initiation of antiretroviral therapy in HIV facilities in Lilongwe, Malawi. PLoS One. 2018; 13(1): e0188488. https://doi.org/10.1371/journal.pone.0188488 29373574

44. Arnesen R, Moll AP, Shenoi SV. Predictors of loss to follow-up among patients on ART at a rural hospital in KwaZulu-Natal, South Africa. PLoS One. 2017; 12(5): e0177168. https://doi.org/10.1371/journal.pone.0177168 28542309

45. Boyles TH, Wilkinson LS, Leisegang R, Maartens G. Factors influencing retention in care after starting antiretroviral therapy in a rural South African programme. PLoS One. 2011; 6(5): e19201. https://doi.org/10.1371/journal.pone.0019201 21559280

46. Charurat M, Oyegunle M, Benjamin R, Habib A, Eze E, Ele P, et al. Patient retention and adherence to antiretrovirals in a large antiretroviral therapy program in Nigeria: a longitudinal analysis for risk factors. PLoS One. 2010; 5(5): e10584. https://doi.org/10.1371/journal.pone.0010584 20485670

47. Grimsrud A, Balkan S, Casas EC, Lujan J, Van Cutsem G, Poulet E, et al. Outcomes of antiretroviral therapy over a 10-year period of expansion: a multicohort analysis of African and Asian HIV programs. J Acquir Immune Defic Syndr. 2014; 67(2): e55–66. https://doi.org/10.1097/QAI.0000000000000268 24977472

Same-day antiretroviral therapy initiation for HIV-infected adults in South Africa: Analysis of routine data

Souhrn

Klíčová slova:

Zdroje

PLOS One

Současné pohledy na riziko v parodontologii

Svět praktické medicíny 3/2024 (znalostní test z časopisu)

Kardiologické projevy hypereozinofilií

Střevní příprava před kolonoskopií

Aktuální možnosti diagnostiky a léčby litiáz