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Antiretroviral Therapy Initiation during Acute/Early HIV Infection vs. Later ART Initiation is Associated with Improved Immunologic and Virologic Parameters during Suppressive ART
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Reported by Jules Levin
CROI 2011 March 2 Boston
Steve Deeks, MD: "Our data suggests that the early initiation of antiretroviral therapy (within the first 6 months) is strongly associated with lower levels of T cell activation than that observed in those who defer therapy until later in the disease. Importantly, this residual effect of delayed therapy is evident after years of treatment, suggesting that the harm to the immune system that is associated with delaying therapy might prove irreversible. Based on what we know about the impact of chronic inflammation on the overall aging process, this low-level persistent inflammation might be expected to contribute to disease once people are older.
Although our data indicate that early therapy is indeed beneficial in terms of the immunologic outcomes, it unfortunately suggests that even in the context of optimal therapy, some residual T cell activation persists (i.e., the early initiation of therapy does not appear to normalize T cell activation)."
Vivek Jain1, Wendy Hartogensis1, Peter Bacchetti2, Peter Hunt1, Lorrie Epling1, Elizabeth Sinclair1,Tzong-Hae Lee,3Michael Busch3, Christopher Pilcher1, Frederick Hecht1and Steven Deeks1HIV/AIDS Division, San Francisco General Hospital, Univ. of California, San Francisco, USA1; Dept. of Epidemiology and Biostatistics, San Francisco, USA2, Blood Systems Research Institute, San Francisco, USA3
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