Implementing rapid ART initiation to successfully manage HIV

As countries across the globe continue the fight against HIV, treatments that are quickly initiated and effective are crucial for getting patients with HIV virally suppressed both to improve their clinical outcomes and to stop the transmission of infection.

Addressing both of these issues, Mary Montgomery, MD, associate physician in the Division of Infectious Diseases at Brigham and Women’s Hospital, and an instructor of medicine at Harvard Medical School, discussed emerging treatment strategies for managing HIV during a session at the National Association of Managed Care Physicians 2019 Fall Managed Care Forum, held October 10-11 in Las Vegas, Nevada.

More and more, clinicians are understanding the benefit of prescribing antiretroviral therapy (ART) to patients the day they are diagnosed with HIV, otherwise known as rapid ART initiation.

The literature has shown that rapid ART initiation is associated with a more favorable mortality profile, as well as quicker viral suppression. In one study,1 the median time to viral suppression was 56 days for those who initiated treatment at diagnosis, compared with 126 days for those who began treatment consistent with prior recommendations for universal ART and 219 days for those who received CD4-guided ART.

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