HIV/AIDSStudy finds starting treatment early can reduce risk of death&related complications

The benefit for patients who received early treatment seemed to come from lower rates of tuberculosis and in lower rates of cancer, including types of cancer not associated with AIDS.

New studies have found that starting therapy before AIDS symptoms appear can dramatically delay the development of AIDS-related events and death.

This is according to two studies released by the New England Journal of Medicine.

Until now, evidence on when to begin the treatment of asymptomatic patients has not been clear, and there's been concern that giving antiretroviral therapy earlier might increase patients’ risk of cardiovascular and renal disease.

Study co-author,  Dr. Jens Lundgren of Rigshospitalet at the University of Copenhagen said time of treatment for HIV had been a controversy for a while, hence the need to settle it.

In his team’s study, 4,685 HIV-positive adults were followed for an average of 3 years. Half were randomly assigned to start taking antiretroviral drugs immediately, while their CD4-positive counts were still higher than 500.

In the remaining volunteers, treatment was delayed until their counts dropped to 350.

The findings were so dramatic, the test was terminated prematurely and all patients were put on antiretroviral therapy.

According to Lundgren, "we are demonstrating a benefit from treatment with what we could consider to be a normal CD4-positive count. From that logic, everybody (who is HIV positive) should be treated because in any patient who is HIV infected but with a high CD4-positive count there is some immune deficiency that antiretroviral treatment can essentially repair."

The benefit for patients who received early treatment seemed to come from lower rates of tuberculosis and in lower rates of cancer, including types of cancer not associated with AIDS.

play (Medicine Net)

The study, initiated in 2009, was done by the International Network for Strategic Initiatives in Global HIV Trials (INSIGHT) and involved volunteers treated at 215 sites in 35 countries.

The second study, by Xavier Anglaret of INSERM in Bordeaux, France and colleagues, reached a similar conclusion.

That team followed 2,056 infected patients at nine care centers in Abidjan, the economic capital of Ivory Coast, and they looked at volunteers whose CD4-positive counts were above or below 500, the standard set by the World Health Organization.

In the end, both researches concluded that antiretroviral therapy "provides substantial clinical benefits in patients who have higher CD4+ counts at the time of initiation than those previously recommended for the initiation of ART,"