Temporal trends from HIV diagnosis to ART initiation among adults living with HIV in the Asia–Pacific (2013–2023)

作者：Thinh Toan Vu, Dhanushi Rupasinghe, Vohith Khol, Romanee Chaiwarith, Junko Tanuma, Nagalingeswaran Kumarasamy, Suwimon Khusuwan, IKetut Agus Somia, Sanjay Pujari, Man Po Lee, Rohidas Borse, Sasisopin Kiertiburanakul, Evy Yunihastuti, Iskandar Azwa, Jun Yong Choi, Hsin‐Pai Chen, Rossana Ditangco, Anchalee Avihingsanon, Yasmin Gani, Jeremy A. Ross, Awachana Jiamsakul, on behalf of IeDEA Asia-Pacific · 发表于：AIDS Research and Therapy · 年份：2025 · DOI：10.1186/s12981-025-00718-8 · 被引用次数：3 · 研究领域：HIV/AIDS Research and Interventions、HIV Research and Treatment、HIV/AIDS drug development and treatment

INTRODUCTION: Data on the impact of World Health Organization (WHO)'s guideline changes and COVID-19 on ART initiation in the Asia-Pacific remain scarce. This study described temporal trends from HIV diagnosis to ART initiation from 2013 to 2023 and its associated factors. METHODS: Adults (≥ 18 years) diagnosed with HIV after 2013 in a regional observational cohort were included. Fine and Gray competing risk regression examined predictors of ART initiation (≥ 3 antiretroviral medications), accounting for those lost to follow-up or deceased before treatment considered as competing risks. RESULTS: Among 14,968 participants, most were male (70.1%), with a median age of 36 years (interquartile range [IQR]: 28-44). At HIV diagnosis, median CD4 count was 208 cells/µL (IQR: 69-395), and median viral load was 86,296 copies/mL (IQR: 13,186-392,000). Over 85% of participants had initiated ART during the study period. Median time from HIV diagnosis to ART initiation differed across years of HIV diagnosis: 51 days (2013-2015), 28 days (2016-2019), and 26 days (≥ 2020). Factors associated with shorter time to ART initiation were higher country income-level (upper-middle: sub-distribution hazard ratio [SHR] = 1.34, 95% CI: 1.28, 1.40; high: SHR = 1.35, 95% CI: 1.28, 1.43; vs. lower-middle); HIV transmission via male-to-male contact (SHR = 1.06, 95% CI: 1.02, 1.11) or injection drug use (SHR = 1.23, 95% CI: 1.09, 1.38; vs. heterosexual contact); and later years of HIV diagnosis (2016-2019: ...