{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T17:47:55Z","timestamp":1776361675225,"version":"3.51.2"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2020,5,5]],"date-time":"2020-05-05T00:00:00Z","timestamp":1588636800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007553","name":"Aids Fonds","doi-asserted-by":"publisher","award":["2013169"],"award-info":[{"award-number":["2013169"]}],"id":[{"id":"10.13039\/100007553","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Bristol-Myers Squibb International Corporation","award":["AI424-541"],"award-info":[{"award-number":["AI424-541"]}]},{"name":"Gilead Sciences Europe Ltd","award":["PA-HIV-PREP-16\u20130024"],"award-info":[{"award-number":["PA-HIV-PREP-16\u20130024"]}]},{"DOI":"10.13039\/100005564","name":"Gilead Sciences","doi-asserted-by":"publisher","award":["CO-NL-276\u20134222"],"award-info":[{"award-number":["CO-NL-276\u20134222"]}],"id":[{"id":"10.13039\/100005564","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005564","name":"Gilead Sciences","doi-asserted-by":"publisher","award":["CO-US-276\u20131712"],"award-info":[{"award-number":["CO-US-276\u20131712"]}],"id":[{"id":"10.13039\/100005564","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008897","name":"Janssen Pharmaceuticals","doi-asserted-by":"publisher","award":["PHNL\/JAN\/0714\/0005b\/1912fde"],"award-info":[{"award-number":["PHNL\/JAN\/0714\/0005b\/1912fde"]}],"id":[{"id":"10.13039\/100008897","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001826","name":"ZonMw","doi-asserted-by":"publisher","award":["522002003"],"award-info":[{"award-number":["522002003"]}],"id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Stichting HIV Monitoring"},{"DOI":"10.13039\/501100002999","name":"Dutch Ministry of Health, Welfare and Sport","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002999","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National Institute for Public Health and the Environment"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Men who have sex with men (MSM) with acute human immunodeficiency virus (HIV) infection (AHI) are a key source of new infections. To curb transmission, we implemented a strategy for rapid AHI diagnosis and immediate initiation of combination antiretroviral therapy (cART) in Amsterdam MSM. We assessed its effectiveness in diagnosing AHI and decreasing the time to viral suppression.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We included 63 278 HIV testing visits in 2008\u20132017, during which 1013 MSM were diagnosed. Standard of care (SOC) included HIV diagnosis confirmation in &amp;lt; 1 week and cART initiation in &amp;lt; 1 month. The AHI strategy comprised same-visit diagnosis confirmation and immediate cART. Time from diagnosis to viral suppression was assessed for 3 cART initiation periods: (1) 2008\u20132011: cART initiation if CD4 &amp;lt; 500 cells\/\u03bcL (SOC); (2) January 2012\u2013July 2015: cART initiation if CD4 &amp;lt; 500 cells\/\u03bcL, or if AHI or early HIV infection (SOC); and (3a) August 2015\u2013June 2017: universal cART initiation (SOC) or (3b) August 2015\u2013June 2017 (the AHI strategy).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Before implementation of the AHI strategy, the proportion of AHI among HIV diagnoses was 0.6% (5\/876); after implementation this was 11.0% (15\/137). Median time (in days) to viral suppression during periods 1, 2, 3a, and 3b was 584 (interquartile range [IQR], 267\u20131065), 230 (IQR, 132\u2013480), 95 (IQR, 63\u2013136), and 55 (IQR, 31\u201372), respectively (P &amp;lt; .001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Implementing the AHI strategy was successful in diagnosing AHI and significantly decreasing the time between HIV diagnosis and viral suppression.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciaa505","type":"journal-article","created":{"date-parts":[[2020,4,29]],"date-time":"2020-04-29T11:17:34Z","timestamp":1588159054000},"page":"1952-1960","source":"Crossref","is-referenced-by-count":24,"title":["Decreased Time to Viral Suppression After Implementation of Targeted Testing and Immediate Initiation of Treatment of Acute Human Immunodeficiency Virus Infection Among Men Who Have Sex With Men in Amsterdam"],"prefix":"10.1093","volume":"72","author":[{"given":"Maartje","family":"Dijkstra","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, Public Health Service, Amsterdam, The Netherlands"},{"name":"Division of Infectious Diseases, Department of Internal Medicine, Amsterdam Institute for Infection and Immunity, Amsterdam University Medical Center, University of Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martijn S","family":"van Rooijen","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Public Health Service, Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariska M","family":"Hillebregt","sequence":"additional","affiliation":[{"name":"Stichting HIV Monitoring, Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ard","family":"van Sighem","sequence":"additional","affiliation":[{"name":"Stichting HIV Monitoring, Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Colette","family":"Smit","sequence":"additional","affiliation":[{"name":"Stichting HIV Monitoring, Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arjan","family":"Hogewoning","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Public Health Service, Amsterdam, The Netherlands"},{"name":"Division of Infectious Diseases, Department of Internal Medicine, Amsterdam Institute for Infection and Immunity, Amsterdam University Medical Center, University of Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Udi","family":"Davidovich","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Public Health Service, Amsterdam, The Netherlands"},{"name":"Division of Infectious Diseases, Department of Internal Medicine, Amsterdam Institute for Infection and Immunity, Amsterdam University Medical Center, University of Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Titia","family":"Heijman","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Public Health Service, Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elske","family":"Hoornenborg","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Public Health Service, Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Reiss","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine, Amsterdam Institute for Infection and Immunity, Amsterdam University Medical Center, University of Amsterdam, The Netherlands"},{"name":"Stichting HIV Monitoring, Amsterdam, The Netherlands"},{"name":"Department of Global Health, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands"},{"name":"Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc","family":"van der Valk","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine, Amsterdam Institute for Infection and Immunity, Amsterdam University Medical Center, University of Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Prins","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Public Health Service, Amsterdam, The Netherlands"},{"name":"Division of Infectious Diseases, Department of Internal Medicine, Amsterdam Institute for Infection and Immunity, Amsterdam University Medical Center, University of Amsterdam, The 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