This publication presents the results of San Francisco General Hospital's Ward 86 pilot study of immediate ART initiation. This RAPID program systematically offered ART to patients upon diagnosis of HIV; patients were referred from HIV testing sites in San Francisco. Of the 39 patients who participated in the pilot, 95% of them started ART within 24 hours. Median time to viral suppression (<200 copies/mL) was 1.8 months, as compared with 4.3 months with a historic standard-of-care (universal ART) comparison group; retention in care was very high. Since this pilot, the immediate ART initiation has become standard clinic practice at Ward 86 as part of San Francisco's "Getting to Zero" initiative.
References
- Pilcher CD, Ospina-Norvell C, Dasgupta A, et al. The effect of same-day observed initiation of antiretroviral therapy on HIV viral load and treatment outcomes in a U.S. public health setting. J Acquir Immune Defic Syndr. 2016 Jul 16. [Epub ahead of print]
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About Susa Coffey, MD
Susa Coffey is medical editor of the NCRC. She is a Professor of Medicine at UCSF in the Division of HIV, Infectious Diseases and Global Medicine. Also, she is a longtime clinician and educator in HIV at San Francisco General Hospital clinic (“Ward 86”). She is also the Medical Editor of HIV InSite. Dr. Coffey is Co-Lead of the RAPID clinical program at Ward 86, San Francisco General Hospital and the Chair of the RAPID Committee of San Francisco's Getting to Zero campaign.