Benefits of early HIV treatment

Sustained treatment of HIV infection early on in the disease can have long term benefits for patients, researchers reported last night.

The British led study tested the benefits of treating patients with anti-viral drugs for 48 weeks as early as possible in the course of infection.

Research was undertaken in countries such as Australia, South Africa, Brazil, Spain, Italy and Ireland.

It involved some 366 adults over five years.

Reporting in the New England Journal of Medicine, the researchers say the treatment reduced viral levels in the blood for up to 60 weeks after treatment was stopped.

It also delayed the need for long-term treatment – although the delay was only a little longer than the 48 weeks that patients had already spent on drugs.

Researcher Dr Sarah Fidler, from Imperial College London, said: "These results are promising and suggest that a year-long course of treatment for people recently infected with HIV may have some benefit on both the immune system as well as helping control the virus.

"The treatment also reduces the amount of virus in the body for some time after the patient has stopped taking the medication. This could be very important for helping reduce the risk of passing on the virus to a sexual partner."

Professor Gita Ramjee, director of the South African Medical Research Council’s HIV Prevention Research Unit, said: "We now need to weigh up whether the benefits offered by early intervention are outweighed by the strategic and financial challenges such a change in policy would incur, particularly in resource-poor settings such as Africa, although this may be where the most benefits are seen in terms of TB rates."

SPARTAC Trial Investigators. The effect of short-course antiretroviral therapy in primary HIV infection: final results from SPARTAC, an international randomized controlled trial. NEJM; 17 Jan 2013.