In people with a primary HIV infection, the need to restart treatment during chronic HIV infection can be delayed if they receive a 24-week long temporary therapy with antiretroviral drugs (cART). The study findings published in this week’s PLoS Medicine are significant, given that treatment for HIV-infected individuals is currently often deferred until their CD4 count drops below a certain level (350) or is based on clinical symptoms.
Leading researcher, Marlous Grijsen, from the Academic Medical Center at the University of Amsterdam in the Netherlands, recruited 168 patients with primary HIV infection who were randomized to either receive 24 or 60 weeks of cart or no treatment.
They discovered that the average viral setpoint, i.e. the stable point that is reached in the amount of virus in the blood after the immune system begins to produce HIV antibodies, was lower in the cART group who received early therapy compared with those who received no treatment.
In addition, patients in the no-treatment group started long-term cART therapy on average 0.7 years after randomization, whilst patients in the 24-week cART group started their long-term cART therapy after 3 years, and those in the 60-week cART group after 1.8 years.
The researchers conclude:
“This randomized study demonstrates a clear clinical benefit of temporary cART initiated during [primary HIV Infection]. Early cART transiently lowered the viral set point and deferred the need for restart of cART during chronic HIV infection.
Although extended follow-up studies are needed to evaluate the long-term benefits of such early treatment, starting cART when the patient is ready to do so seems the most reasonable advice for patients with [primary HIV Infection].”
Written by Grace Rattue