Education, Science, Technology, Innovation and Life
Open Access
Sign In
  1. Home
  2. Journals
  3. MEDS Basic Medicine
  4. Vol 4, Issue 1, 2026

Rapid versus conventional initiation of antiretroviral therapy in patients with HIV/AIDS: A meta-analysis of effectiveness and adherence

Download as PDF

DOI: 10.23977/medbm.2026.040104 | Downloads: 2 | Views: 239

Author(s)

Hao Li 1,2, Kejia Zhou 1,2, Wenxi Tang 1,2

Affiliation(s)

1 Department of Pharmacoeconomics, School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, Jiangsu, China
2 Center for Pharmacoeconomics and Outcomes Research, China Pharmaceutical University, Nanjing, Jiangsu, China

Corresponding Author

Wenxi Tang

ABSTRACT

A systematic search of PubMed, Web of Science, CNKI, and VIP databases was conducted to identify clinical studies comparing rapid and conventional ART initiation in patients with HIV/AIDS. Two researchers independently performed literature screening and data extraction, and meta-analysis was conducted using Review Manager 5.4 software. A total of 20 clinical studies (19 cohort studies and 1 randomized controlled trial) were ultimately included, comprising 136,192 patients in the rapid initiation group and 234,945 patients in the conventional initiation group. The meta-analysis indicated that the rapid initiation group had a significantly higher viral suppression rate [RR ＝ 1.04,95%CI: (1.01,1.08),P =0.01] compared to the conventional initiation group. Furthermore, the mortality rate [RR ＝ 0.67,95%CI : (0.52, 0.87),P = 0.003] and loss to follow-up rate [RR ＝ 0.62,95%CI: (0.50, 0.77),P < 0.0001] in the rapid initiation group were significantly lower than those in the conventional initiation group. Compared with conventional initiation, the rapid ART initiation strategy can significantly improve the viral suppression rate and effectively reduce all-cause mortality and the risk of loss to follow-up among HIV/AIDS patients, demonstrating superior clinical effectiveness and treatment adherence.

KEYWORDS

Rapid initiation, Antiretroviral Therapy, HIV/AIDS, Meta-analysis

CITE THIS PAPER

Hao Li, Kejia Zhou, Wenxi Tang. Rapid versus conventional initiation of antiretroviral therapy in patients with HIV/AIDS: A meta-analysis of effectiveness and adherence. MEDS Basic Medicine (2026). Vol. 4, No. 1, 28-37. DOI: http://dx.doi.org/10.23977/medbm.2026.040104.

REFERENCES

[1] National AIDS and STD Epidemic in December 2024 [J]. Chinese Journal of AIDS & STD,2025,31(03):225.(in Chinese)
[2] Cohen M, Chen Y Q, Mccauley M, et al. Prevention of HIV-1 Infection with Early Antiretroviral Therapy[J]. The New England journal of medicine,2011.
[3] Consolidated Guidelines on HIV Prevention, Testing, Treatment, Service Delivery and Monitoring: Recommendations for a Public Health Approach[M]. Geneva: World Health Organization,2021.
[4] Group T I S S. Initiation of Antiretroviral Therapy in Early Asymptomatic HIV Infection[J]. New England Journal of Medicine,2015,373(9):795-807.
[5] Volz E M, Ionides E, Romero-Severson E O, et al. HIV-1 transmission during early infection in men who have sex with men: a phylodynamic analysis[J]. PLoS medicine, 2013, 10(12): e1001568.
[6] Gandhi R T, Bedimo R, Hoy J F, et al. Antiretroviral Drugs for Treatment and Prevention of HIV Infection in Adults: 2022 Recommendations of the International Antiviral Society–USA Panel[J]. JAMA,2023,329(1):63-84.
[7] U.S. Department of Health and Human Services. Guidelines for the prevention and treatment of opportunistic infections in adults and adolescents with HIV[J], Updated: 2023.
[8] European AIDS Clinical Society. EACS Guidelines version 12.1. https://eacs.sanfordguide.com[J]. 2024.
[9] Shen Y Z. Chinese Guidelines for Diagnosis and Treatment of HIV/AIDS (2024 Edition) [J]. Chinese Journal of AIDS & STD,2024,30(08):779-806. (in Chinese)
[10] Medical Administration Bureau. National Health Commission of the People's Republic of China. National Free Antiretroviral Therapy Drug Manual (2023 Edition) [M]. Beijing: People's Medical Publishing House, 2023:46-52. (in Chinese)
[11] Group T T A S. A Trial of Early Antiretrovirals and Isoniazid Preventive Therapy in Africa[J]. The New England Journal of MedicineNEJM,2015,373(9).
[12] Insight Start Study Group. Lundgren Jd B A G D. Initiation of Antiretroviral Therapy in Early Asymptomatic HIV Infection[J]. New England Journal of Medicine,2015,373(9):795-807.
[13] Aksoy N , Ozturk N , Agh T ,et al.Adherence to the antirheumatic drugs: a systematic review and meta-analysis[J].Frontiers in Medicine, 2024.DOI:10.3389/fmed.2024.1456251. 
[14] Mateo-Urdiales A, Johnson S, Smith R, et al. Rapid initiation of antiretroviral therapy for people living with HIV[J]. Cochrane database of systematic reviews (Online),2019,6(11). 
[15] Chow S M , Tan B K .Effectiveness of mHealth apps on adherence and symptoms to oral anticancer medications: a systematic review and meta-analysis[J].Supportive Care in Cancer, 2024, 32(7):1-13.DOI:10.1007/s00520-024-08635-8.
[16] Coffey S, Bacchetti P, Sachdev D, et al. RAPID antiretroviral therapy: high virologic suppression rates with immediate antiretroviral therapy initiation in a vulnerable urban clinic population[J]. AIDS,2019(5):33.
[17] Huhn G D, Gordon C, Moti R, et al. Darunavir/Cobicistat/Emtricitabine/Tenofovir Alafenamide in a Rapid-Initiation Model of Care for Human Immunodeficiency Virus Type 1 Infection: Primary Analysis of the DIAMOND Study[J]. Clinical Infectious Diseases,2019.
[18] Teeraananchai S, Boettiger D C, Lertpiriyasuwat C, et al. The impact of same-day and rapid ART initiation under the Universal HealthCoverage programme on HIV outcomes in Thailand: a retrospective real-life cohortstudy[J]. J Int AIDS Soc,2025,28(1):e26406.
[19] Zhang X, Guan H, Di X, et al. Clinical benefits of rapid initiation of antiretroviral therapy within 14 daysfor newly diagnosed late-presentation people living with human immune deficiency virus (PLWH)[J]. Drug Discov Ther, 2025,19(2):112-123.
[20] Duggan J M, Himich K V, Sahloff E G. Assessment of Virologic Suppression and Retention in Care 6 Years After RapidInitiation of Antiretroviral Therapy[J]. Open Forum Infect Dis,2025,12(3):ofaf122.
[21] Mauleti I Y, Wibisana K A, Syamsuridzal D P, et al. Rapid Antiretroviral Therapy Initiation Reduces Mortality Among People LivingWith HIV in Indonesia: A Retrospective Observational Study[J]. J Prev Med Public Health,2025,58(4):360-369.
[22] Wang R, Sun L, Wang X, et al. Rapid Initiation of Antiretroviral Therapy With Coformulated Bictegravir, Emtricitabine, and Tenofovir Alafenamide Versus Efavirenz, Lamivudine, and Tenofovir Disoproxil Fumarate in HIV-Positive Men Who Have Sex With Men in China: Week 48 Results of the Multicenter, Randomized Clinical Trial[J]. Clin Infect Dis,2024,79(1):169-176.
[23] Mgbako O, Mathu R, Gonzalez Davila M, et al. Immediate ART and clinical outcomes in New York City among patients newly diagnosed with HIV[J]. AIDS Care,2023,35(4):545-554.
[24] Ross J, Brazier E, Fatti G, et al. Same-Day Antiretroviral Therapy Initiation as a Predictor of Loss to Follow-upand Viral Suppression Among People With Human Immunodeficiency Virus inSub-Saharan Africa[J]. Clin Infect Dis, 2023,76(1):39-47.
[25] Eamsakulrat P, Kiertiburanakul S. The Impact of Timing of Antiretroviral Therapy Initiation on Retention in Care,Viral Load Suppression and Mortality in People Living with HIV: A Study in a University Hospital in Thailand[J]. J Int Assoc Provid AIDS Care,2022,21:23259582221082607.
[26] Kimanga D O, Oramisi V A, Hassan A S, et al. Uptake and effect of universal test-and-treat on twelve months retention andinitial virologic suppression in routine HIV program in Kenya[J]. PLoS One,2022,17(11):e0277675.
[27] O'Shea J G, Gallini J W, Cui X, et al. Rapid Antiretroviral Therapy Program: Development and Evaluation at a VeteransAffairs Medical Center in the Southern United States[J]. AIDS Patient Care STDS,2022,36(6):219-225.
[28] Zhao B, Ding H, Song W, et al. Antiretroviral therapy initiation within 7 and 8-30 st-HIV diagnosis demonstrates similar benefits in resource-limited settings[J]. AIDS,2022,36(12):1741-1743.
[29] Bacon O, Chin J, Cohen S E, et al. Decreased Time From Human Immunodeficiency Virus Diagnosis to Care, Antiretroviral Therapy Initiation, and Virologic Suppression during the CitywideRAPID Initiative in San Francisco[J]. Clin Infect Dis,2021,73(1):e122-e128.
[30] Yang Y, Li Y, Zhang X, et al. Effect of antiretroviral therapy initiation time and baseline CD4(+) cell countson AIDS-related mortality among former plasma donors in China: a 21-yearretrospective cohort study[J]. Glob Health Action,2021,14(1):1963527.
[31] Yang B L, et al. Under the integration model of medical and prevention, Wuxi City, Jiangsu Province carried out AIDS rapid initiation treatment and effect evaluation. Disease Surveillance 40.11(2025):1382-1389. (in Chinese)
[32] Xin J Y, et al. Effect of rapid initiation therapy on viral suppression in HIV/AIDS patients." Practical Preventive Medicine 32.02(2025):149-154. (in Chinese)
[33] Tian B, et al. Observation of the effectiveness of rapid start of HIV antiretroviral treatment and analysis of influencing factors. Journal of Kunming Medical University 45.09(2024):163-167. (in Chinese)
[34] Zhai Y Y, et al. Effect of rapid initiation of antiviral therapy on antiviral treatment outcomes in human immunodeficiency virus infected patients." Infectious Disease Information 37.04(2024):294-298. (in Chinese)
[35] Zhou Z, et al. Effect of rapid initiation of antiretroviral therapy on virologic suppression in HIV/AIDS patients." Infectious Disease Information 36.04(2023):336-340+345. (in Chinese)
[36] Peng L. Evaluation of the virological efficacy of rapid initiation of antiretroviral therapy in HIV-infected patients.2023.China Medical University, MA thesis. 2023.002152. (in Chinese)
[37] Du H C, et al. Effect of antiviral treatment initiation after diagnosis of HIV infected patients on viral inhibition." Chinese Journal of AIDS and Venereal Diseases 27.11(2021):1218-1223. (in Chinese)

Subscription
E-Mail Alert
Most popular papers
Call for Special Issue
Publication Ethics & OA Statement
Plagiarism Policy
Contact Us
Downloads: 1932
Visits: 136171

Sponsors, Associates, and Links

All published work is licensed under a Creative Commons Attribution 4.0 International License.

Copyright © 2016 - 2031 Clausius Scientific Press Inc. All Rights Reserved.