Birmingham, AL—Providing speedy treatment for HIV patients pays off, according to a nationwide clinical trial.

In fact, a presentation at the Conference on Retroviruses and Opportunistic Infections in Seattle reported that 86% of patients entering HIV care soon after diagnosis maintained viral suppression after 48 weeks during a clinical trial conducted at four National Institutes of Health–funded Centers for AIDS Research across the United States.

Participants in the iENGAGE trial achieved viral suppression in an average of just 63 days.

The study presented by Michael J. Mugavero, MD, of the University of Alabama at Birmingham posited, “Optimizing engagement in HIV care represents the greatest opportunity to maximize the individual and population health benefits of sustained viral suppression.”

Study participants, who began treatment within 14 days of diagnosis, were randomized to an intervention or standard-of-care control arm, and the intervention integrated and adapted two evidence-based approaches with demonstrated efficacy for treatment adherence, including enhanced personal contact or reminders and a four-session counseling program.

The study, conducted from December 2013 to June 2016, found that many of the patients new to care had “substantial co-morbid psychosocial illness and unmet need for supportive services.”

The higher-than-expected-viral suppression rate “likely reflects a rapidly evolving HIV treatment landscape, which emphasizes the care continuum, rapid ART initiation and the emergence of integrase inhibitors as first-line therapies,” the study authors suggest, emphasizing the important of sustaining care engagement beyond the first year.

Researchers write that the following improvements in care are affecting HIV treatment in the United States:
• Changes in HIV treatment guidelines to encourage early treatment for everyone diagnosed with HIV
• An increased focus in clinical practice guidelines on retaining people in the HIV care continuum from diagnosis to viral suppression
• The inclusion of integrase inhibitors—a new, potent, and well-tolerated class of antiretroviral drugs—in first-line ART regimens

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