Delaying HIV Progression?

(Ivanhoe Newswire) -- A New England Journal of Medicine study has announced that short-course antiretroviral therapy (ART) in primary human immunodeficiency virus (HIV) infection may delay disease progression, but has not been adequately evaluated.

ART consists of the combination of antiretroviral drugs to suppress the HIV virus and stop the progression of HIV disease.

Researchers randomly assigned adults with primary HIV to ART for 48 weeks, ART for 12 weeks, or no ART (standard of care). The primary end point was a CD4+ count, a blood test to determine how well the immune system is working, of less than 350 cells per cubic millimeter or long-term ART initiation.

Out of the 366 participants, 123 patients underwent 48-week ART, 120 participants did the 12-week ART, and 123 assumed standard care. The primary end point was reached in 50% of the 48-week ART group, compared to 61% in each of the 12-week ART and standard care groups. The proportion of people who had a CD4+ count of less than 350 cells per cubic millimeter was 28% in the 48-week ART group, 40% in the 12-week group and the standard care group.

The average time to the primary end point was 65 weeks longer with 48-week ART than with standard care. “Post hoc analysis identified a trend toward a greater interval between ART initiation and the primary end point the closer that ART was initiated to estimated seroconversion and 48-week ART caused a reduction in the HIV RNA level of 0.44 log10 copies per milliliter 36 weeks after the completion of short-course therapy.” There were no significant differences between the groups in the incidence of the acquired immunodeficiency syndrome, death, or serious adverse events.

This study showed a 48-week course of ART in patients with primary HIV infection delayed disease progression, but not significantly longer than the duration of the treatment.

SOURCE: New England Journal of Medicine, January 2013