Association Between Timing of Antiretroviral Therapy Initiation After HIV Diagnosis and Changes in CD4 Counts and Viral Load Among Newly Diagnosed HIV Patients in a Short-term Study at Debaratana Nakhonratchasima Hospital

Abstract

            Introduction: Current HIV treatment guidelines recommend immediate initiation of antiretroviral therapy (ART), regardless of CD4 cell count. Evidence suggests that early ART initiation leads to better treatment outcomes. However, optimal timing for initiating ART remains to be fully elucidated.

            Objective: This study aimed to investigate the clinical outcomes of newly diagnosed HIV-infected patients and to compare the effectiveness of different ART initiation timing groups using standard treatment regimens.

            Methods: A cross-sectional study was conducted among newly diagnosed HIV-infected patients at Debaratana Nakhonratchasima Hospital, between April 2016 and June 2021. Patients were divided into three groups based on the timing of ART initiation: Early ART (within 15 days), Intermediate ART (16-29 days), and Late ART (30 days or more). Data was analyzed using descriptive statistics, independent t-tests, Z-tests, and Pearson correlation.

            Results: A total of 194 patients were included in the study: 64 in the Early ART group, 54 in the Intermediate ART group, and 76 in the Late ART group. Results showed that patients who initiated ART early had significantly higher CD4 counts and CD4 percentages compared to the other groups (p-value = 0.001). All groups achieved viral suppression, but the Late ART group demonstrated slightly better viral suppression. There was no significant difference in weight change among the groups, indicating that weight change was not directly related to the timing of ART initiation.

            Conclusion: Initiating ART within 30 days of diagnosis was associated with improved immune recovery, particularly in terms of CD4 cell counts, and better treatment outcomes. These findings support the recommendation for early initiation of ART in newly diagnosed HIV-infected individuals.