Newspaper article The Canadian Press

Key Studies Support Case for Starting HIV Drug Treatment Right after Diagnosis

Newspaper article The Canadian Press

Key Studies Support Case for Starting HIV Drug Treatment Right after Diagnosis

Article excerpt

Key studies back case for early HIV treatment


TORONTO - Final results from two landmark studies have added more scientific weight to the case for starting HIV treatment immediately after diagnosis to help preserve an infected person's health and to prevent transmission of the virus to others.

The evidence of the two clinical trials presented Monday at the 8th International AIDS Society (IAS) conference on HIV Pathogenesis, Treatment and Prevention in Vancouver will play a significant role as the World Health Organization crafts updated HIV treatment guidelines, said Gottfried Hirnschall, director of the agency's HIV department.

In the START trial -- for Strategic Timing of AntiRetroviral Treatment -- almost 4,700 HIV-positive adults in 35 countries were randomized to receive either antiretroviral drugs soon after diagnosis or deferred treatment with the medications when the number of immune cells known as CD4s had dropped below a certain point.

The study was halted in May after interim results showed that immediate treatment cut the risk of serious illness or death from HIV-AIDS in half.

On Monday, co-principal investigator Dr. Jens Lundgren of the University of Copenhagen presented final data showing that early therapy not only lowers the risk of AIDS-related diseases, but also the risk of cancer, cardiovascular disease and other non-AIDS-related conditions in infected people.

"The data indicate that (early) treatment should be recommended for all HIV-positive people," Lundgren told a media briefing. "Of course the challenge now will be how to get the 20 (million) to 25 million people (worldwide) not on treatment yet, on treatment."

Ten-year results from the second major trial, known as HPTN 052, showed early treatment of an HIV-infected person dramatically reduces the risk of transmission to an uninfected partner.

The study involved 1,171 heterosexual couples in Africa, Thailand, Brazil and the United States. Infected participants were randomly assigned either to start antiretroviral drugs right away, while their immune system was relatively healthy, or to delay treatment until their immune system weakened or they developed an AIDS-defining illness.

Researchers reported Monday that starting antiretroviral therapy early reduced HIV transmission by 93 per cent over the course of the study. Only eight cases of transmission occurred in partners of infected participants who received antiretroviral therapy. …

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