{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T22:30:02Z","timestamp":1761863402974},"reference-count":25,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2014,12,18]],"date-time":"2014-12-18T00:00:00Z","timestamp":1418860800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2015,4]]},"abstract":"Objectives<\/jats:title>The aim of the study was to identify factors associated with the time between opportunistic disease (OD<\/jats:styled-content>) diagnosis and antiretroviral therapy (ART<\/jats:styled-content>) initiation in HIV<\/jats:styled-content>\u2010infected patients presenting for care with an OD<\/jats:styled-content>, and to evaluate the outcomes associated with any delay.<\/jats:p><\/jats:sec>Methods<\/jats:title>A multicentre cohort study was undertaken in L<\/jats:styled-content>ondon, Paris and L<\/jats:styled-content>ille\/T<\/jats:styled-content>ourcoing. The medical records of patients diagnosed from 2002 to 2012 were reviewed.<\/jats:p><\/jats:sec>Results<\/jats:title>A total of 437 patients were enrolled in the study: 70% were male, the median age was 40 years, 42% were from sub\u2010Saharan Africa, 68% were heterosexual, the median CD4<\/jats:styled-content> count was 40\u2009cells\/\u03bcL, and the most common ODs<\/jats:styled-content> were P<\/jats:styled-content>neumocystis<\/jats:italic> pneumonia (37%), tuberculosis (24%), toxoplasmosis (12%) and K<\/jats:styled-content>aposi's sarcoma (11%). Of these patients, 400 (92%) started ART<\/jats:styled-content> within 24 weeks after HIV<\/jats:styled-content> diagnosis, with a median time from OD<\/jats:styled-content> diagnosis to ART<\/jats:styled-content> initiation of 30 [interquartile range (IQR<\/jats:styled-content>) 16\u201358] days. Patients diagnosed between 2009 and 2012 had a shorter time to ART<\/jats:styled-content> initiation than those diagnosed in earlier years [hazard ratio (HR<\/jats:styled-content>) 2.07; 95% confidence interval (CI<\/jats:styled-content>) 1.58\u20132.72]. Factors associated with a longer time to ART<\/jats:styled-content> initiation were a CD4 count\u2009\u2265\u2009200\u2009cells\/\u03bcL (HR<\/jats:styled-content> 0.30; 95% CI<\/jats:styled-content> 0.20\u20130.44), tuberculosis (HR<\/jats:styled-content> 0.40; 95% CI<\/jats:styled-content> 0.30\u20130.55) and diagnosis in London (HR<\/jats:styled-content> 0.62; 95% CI<\/jats:styled-content> 0.48\u20130.80). Patients initiating \u2018deferred\u2019 ART<\/jats:styled-content> (by \u2265\u200930 days) exhibited no difference in disease progression or immunovirological response compared with patients who had shorter times to ART<\/jats:styled-content> initiation. Patients in the \u2018deferred\u2019 group were less likely to have ART<\/jats:styled-content> modifications (HR<\/jats:styled-content> 0.69; 95% CI<\/jats:styled-content> 0.48\u20131.00) and had shorter in\u2010patient stays (mean 14.2 days shorter; 95% CI<\/jats:styled-content> 8.9\u201319.5 days) than patients in the group whose ART<\/jats:styled-content> was not deferred.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>The time between OD<\/jats:styled-content> diagnosis and ART<\/jats:styled-content> initiation remains heterogeneous and relatively long, particularly in individuals with a high CD4<\/jats:styled-content> count or tuberculosis or those diagnosed in L<\/jats:styled-content>ondon. Deferring ART<\/jats:styled-content> was associated with fewer ART<\/jats:styled-content> modifications and shorter in\u2010patient stays.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hiv.12201","type":"journal-article","created":{"date-parts":[[2014,12,19]],"date-time":"2014-12-19T09:00:17Z","timestamp":1418979617000},"page":"219-229","source":"Crossref","is-referenced-by-count":6,"title":["Time to initiation of antiretroviral therapy in HIV<\/scp>\u2010infected patients diagnosed with an opportunistic disease: a cohort study<\/i>"],"prefix":"10.1111","volume":"16","author":[{"given":"L","family":"Deconinck","sequence":"first","affiliation":[{"name":"UCL Research Department of Infection and Population Health University College London London UK"},{"name":"Decision Sciences in Infectious Disease: Prevention, Control, and Care IAME UMR 1137 Paris Diderot University Sorbonne Paris Cit\u00e9 Paris France"},{"name":"Department of Infectious Diseases Lille School of Medicine Tourcoing Hospital Tourcoing France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Y","family":"Yazdanpanah","sequence":"additional","affiliation":[{"name":"Decision Sciences in Infectious Disease: Prevention, Control, and Care IAME UMR 1137 Paris Diderot University Sorbonne Paris Cit\u00e9 Paris France"},{"name":"Department of Infectious Diseases Bichat\u2010Claude Bernard Hospital Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"RJ","family":"Gilson","sequence":"additional","affiliation":[{"name":"UCL Research Department of Infection and Population Health University College London London UK"},{"name":"The Mortimer Market Centre Central and North West London NHS Foundation Trust London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H","family":"Melliez","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Lille School of Medicine Tourcoing Hospital Tourcoing France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N","family":"Viget","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Lille School of Medicine Tourcoing Hospital Tourcoing France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"V","family":"Joly","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Bichat\u2010Claude Bernard Hospital Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"CA","family":"Sabin","sequence":"additional","affiliation":[{"name":"UCL Research Department of Infection and Population Health University College London London 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