Conference Coverage

RAPID ART program yields clinical benefits in San Francisco


 

REPORTING FROM CROI

– In San Francisco, a citywide program to get all persons with newly diagnosed HIV infections linked to care within 5 working days cut the time to first virologic suppression by more than half and reduced the median time from initiation of care to antiretroviral therapy from nearly 4 weeks to just 1 day, an infectious disease specialist reported.

“We saw significant improvements in time to ART [antiretroviral therapy] initiation and time to first virologic suppression in traditionally vulnerable populations, including racial and ethnic minorities and the homeless. However, disparities remain in some groups,” Oliver Bacon, MD, MPH, of the University of California, San Francisco, and the San Francisco Department of Public Health, said at the Conference on Retroviruses and Opportunistic Infections.

Dr. Oliver Bacon of the University of California, San Francisco, and the San Francisco Department of Public Health

Dr. Oliver Bacon

The goal of the RAPID (Rapid ART Program Initiative for HIV Diagnoses) program, an initiative of the San Francisco Getting to Zero Consortium, is to get all newly diagnosed persons, regardless of their personal circumstances, into care immediately and get them started on ART at the first care visit, unless there is a risk for fatal immune reconstitution inflammatory syndrome.

Under the program, all persons with confirmed HIV diagnoses are linked within 5 working days to care, and at the first care visit, have baseline labs collected, receive counseling, and undergo medical and psychosocial assessment. Patients then begin ART with tenofovir and emtricitabine plus either an integrase inhibitor or a boost of darunavir, with the option of a four-drug regimen if the HIV infection was suspected to have occurred while the patient was taking preexposure prophylaxis.

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