Early HIV therapy curbs transmission
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People infected with the virus that causes AIDS are far less likely to infect their sexual partners if they are put on treatment immediately, instead of waiting until their immune systems begin to deteriorate, according to preliminary results from a large clinical trial released Thursday.
Patients with HIV were 96 percent less likely to pass on the infection if they were taking antiretroviral drugs -- a finding that was so overwhelming that it is likely to change both the way AIDS doctors in the United States treat patients and what treatment policies are adopted by the World Health Organization and other countries, said Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases, which paid for the trial.
The data were so convincing that the trial, due to last until 2015, is effectively being ended early.
There have been previous studies, notably among drug abusers in San Francisco and Vancouver, British Columbia, which concluded that starting patients on drugs immediately would stop them from infecting others. Those studies led UNAIDS, the United Nations' AIDS-fighting agency, to adopt "test and treat" as its goal last year; the policy encourages doctors to start people on treatment as soon as they test positive for HIV. But this finding is the first evidence from a randomized clinical trial, the gold standard in medical research.
AIDS prevention specialists not connected to the trial were enthusiastic. "These results are phenomenal," said Thomas Coates, director of the global health program at the University of California, Los Angeles, and founder of the Center for AIDS Prevention Studies in San Francisco.
The $73 million trial, known as HPTN 052, involved 1,763 couples in 13 cities on four continents. One member of each couple was infected with HIV; the other was not. In half the couples, chosen at random, the infected partner was put on antiretroviral drugs as soon as he or she tested positive for the virus. In the other half, the infected person started treatment only when his or her CD4 count -- a measure of the immune system's strength -- dropped below 250 per cubic millimeter.
In 28 of the couples, the uninfected person became infected with the partner's strain of the virus. Twenty-seven of those 28 infections occurred in couples in which the partner who was infected first was not yet getting treatment.
First Published May 13, 2011 12:00 am
