HIV Update: Same-Day HIV Treatment Improves Viral Suppression

Antiretroviral therapy (ART) has been very helpful in making the deadly human immunodeficiency virus manageable, but a new study reveals that earlier treatment of ART to patients diagnosed with HIV can lead to better health outcomes.

The study, published in the journal PLOS Medicine, suggests that same-day initiation of ART for HIV patients resulted to a better health outcome, in terms of virus suppression, compared to those who who received standard care.

For the study, researchers selected 377 adult patients at two public clinics in Johannesburg. They randomly assigned the patients into two groups. The first group was offered to start treatment on the same day, using rapid lab tests and accelerated counseling and a physical exam, while the other group used the standard treatment procedures, usually requiring three to five more clinic visits over a two- to four-week period.

The researchers the followed both group and discovered that 97 percent of patients in the rapid-initiation group (dubbed the RapIT intervention) had started ART within 90 days, while only 72 percent of the patients in the standard treatment group started with the treatment.

"The RapIT intervention showed clinically meaningful improvements in ART uptake and viral suppression, providing proof of principle that a single-visit treatment approach can have benefits," said Sydney Rosen, lead author of the study and a research professor of global health at BUSPH, in a statement.

Their findings supported their hypothesis that offering patients a chance to start treatment on the same day as their first clinic visit would improve the proportion of patients who made it through all the steps and were successfully established on ART.

The researchers noted that the study was limited by the small number of sites and small sample size, and the generalizability of the results to other settings and to non-research conditions is uncertain.

Nevertheless, researchers recommend that health care providers should consider accelerating the process of ART initiation in many different settings and for different types of patients.