Abstract:
Objectives To evaluate the impact of the integration of medicine and prevention on shortening the time to antiretroviral therapy (ART) initiation, viral suppression, and immune reconstitution, and provide the evidence for optimization of HIV infection control in China.
Methods A retrospective cohort study was conducted in newly diagnosed HIV/AIDS cases in Wuxi, Jiangsu province, from January 1, 2016 to December 31, 2024. Based on the the treatment initiation strategy, the participants were divided into two groups: the conventional ART initiation group (conventional group) from 2016 to 2023 and the rapid ART initiation group under the integration of medicine and prevention (rapid group) in 2024. The differences in viral suppression and immune reconstitution between the two groups were compared.
Results Compared with the conventional group, the rapid group showed an increase in the ART initiation rate within 7 days of diagnosis from 21.58% to 81.68%. The median interval between diagnosis and ART initiation decreased from 15 days (interquartile range (IQR): 8 - 34 days) to 0 days (IQR: 0 - 6 days). After ART initiation, both groups showed significant improvements in CD4+ T cell counts, with better immune reconstitution.in the rapid group.
Conclusions The integration of medicine and prevention, characterized by "diagnosis-epidemiological investigation-treatment" one-stop service, significantly improved the early ART initiation and treatment outcomes, providing essential evidence-based support for rapid ART initiation.
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