del Rio C, Green S, Abrams C, Lennox J; Conference on Retroviruses and Opportunistic Infections.

Program Abstr 8th Conf Retrovir Oppor Infect Conf Retrovir Oppor Infect 8th 2001 Chic Ill. 2001 Feb 4-8; 8: 287 (abstract no. S21).

Emory Univ Sch of Med, Atlanta, GA.

Introduction: In light of the recent advances in antiretroviral therapy, increasing emphasis is being placed on early HIV diagnosis and initiation of treatment. The Public Health Service's recent CDC Prevention Strategy includes as two goals increasing the number of patients who are aware of their HIV diagnosis, and who enter care within three months of diagnosis. However, it is not clear that either of these two goals correlates with successful antiretroviral therapy. Objective: To determine the proportions of newly diagnosed patients who enter into care within 3 months, and whose HIV RNA declines to <400c/ml of plasma. Methods: We studied a cohort of adult, newly diagnosed persons found during a hospital admission at Grady Memorial Hospital in the first 6 months of 1999. A retrospective review of chart and computerized pharmacy records was performed one year after diagnosis. All patients were offered Social Worker assistance, and those with an AIDS defining condition were referred to our outpatient clinic. Other patients were referred to community clinics and were not included in the one-year analysis. Results: 78 patients (61M, 17F) were newly diagnosed. The median age was 40 years (range: 17-74), and the median CD4 cell count was 148 (Range: 1-986). Sixteen (21%) died within one year of diagnosis. Sixty-one were eligible for follow- up. Thirty-six (60%) were seen in the outpatient HIV care clinic within three months of discharge, but only 26 (43%) were seen more than one time. Twenty (33%) were prescribed antiretroviral therapy during the year following diagnosis. Twelve had a subsequent HIV RNA <400c/ml plasma, yet only 8 (13%) of the original cohort had an undetectable viral load at one year after the diagnosis. Conclusion: Less than 1-in-7 newly diagnosed patients had a successful antiretroviral treatment outcome. Most patients dropped out of care within a few months of diagnosis. The road between diagnosis and therapeutic success in this inner-city setting is truly a road less traveled.

Publication Types:

• Meeting Abstracts

Keywords:

• Acquired Immunodeficiency Syndrome
• Adult
• CD4 Lymphocyte Count
• HIV Infections
• HIV Seropositivity
• Humans
• Viral Load
• diagnosis
• therapy

Other ID:

• GWAIDS0007090

UI: 102244586

From Meeting Abstracts