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Effect of early highly active antiretroviral therapy on viral suppression among newly diagnosed men who have sex with men living with human immunodeficiency virus in Xi'an, China
Author(s) -
Wei Xiaoli,
Zhang Yajuan,
Santella Anthony J.,
Wang Lirong,
Zhuang Guihua,
Li Siwen,
Zhang Hailan
Publication year - 2019
Publication title -
journal of medical virology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.782
H-Index - 121
eISSN - 1096-9071
pISSN - 0146-6615
DOI - 10.1002/jmv.25449
Subject(s) - viral load , medicine , logistic regression , immunology , transmission (telecommunications) , virology , lentivirus , men who have sex with men , antiretroviral therapy , human immunodeficiency virus (hiv) , viral disease , syphilis , electrical engineering , engineering
Background The number of men who have sex with men (MSM) living with human immunodeficiency virus (HIV) in China has increased rapidly and thus immediate highly active antiretroviral therapy (HAART) after diagnosis was implemented as a strategy to reduce the HIV transmission. Methods MSM who were diagnosed with HIV and received HAART between 2013 to 2015 in Xi’an were divided into three groups (>350, 200‐350, and <200 cell/μL) according to their baseline CD4+ T cell count. The time of follow‐up was calculated from the first date of receiving HAART to December 31, 2016. The CD4+ T cell count was detected with 1 week before or after HAART. The plasma viral loads were tested after 1, 2, and 3 years of treatment. Results Of 1442 subjects who received HAART, 690 (47.9%) cases were in >350 cell/μL group, whereas 400 (27.7%) cases and 352 (24.4%) cases were in the 200‐350 cell/μL group and <200 cell/μL group, respectively. After 1 year of treatment, the viral suppression rate in the <200 cell/μL group was 91.1%, which was significantly lower than the other two groups. The logistic regression results show that the >350 cell/μL group and 200‐350 cell/μL group predicted higher viral suppression rates. Conclusions Baseline CD4+ T cell count more than 350 cell/μL can improve viral suppression among MSM living with HIV. Furthermore, to reduce the transmission risk, the treatment compliance of people living with HIV with high CD4+ T cell levels should be improved, and their diagnosis to the treatment time should be decreased.