Study findings released early after antiretroviral combo substantially lowers risk
FRIDAY, May 13 (HealthDay News) -- People with HIV may be able to reduce the risk of transmitting the infection to sexual partners by starting an antiretroviral regimen early, while their immune systems are healthy, according the results of the HPTN 052 trial, sponsored by the National Institute of Allergy and Infectious Diseases (NIAID). The trial was slated to end in 2015, but the findings are being released early after a scheduled interim data review by an independent data and safety monitoring board.
Myron Cohen, M.D., of the University of North Carolina in Chapel Hill, and colleagues randomly assigned 1,763 mostly heterosexual couples to one of two groups. In the first, the partner with HIV immediately began a regimen of three antiretroviral drugs, while in the second group the HIV infected partner began treatment only after CD4 counts fell below 250 cells/mm3 or the occurrence of an AIDS-related event. At enrollment, the HIV-infected partners had CD4 counts between 350 and 550 cells/mm3.
In its review, the data and safety monitoring board found 39 cases of HIV infection in partners that were previously uninfected, 28 of which could be linked by genetic analysis to the infected partner; 27 of these new infections linked to the infected partner occurred in couples from the delayed treatment group, and only one occurred in a couple from the immediate treatment group. Based on its review, the data and safety monitoring board recommended that the delayed treatment arm be discontinued and that trial participants be informed of outcomes.
"Previous data about the potential value of antiretrovirals in making HIV-infected individuals less infectious to their sexual partners came largely from observational and epidemiological studies," NIAID director Anthony S. Fauci, M.D., said in a statement. "This new finding convincingly demonstrates that treating the infected individual -- and doing so sooner rather than later -- can have a major impact on reducing HIV transmission."