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Antiretroviral Treatment Prevents HIV Transmission: Final Results from the HPTN 052 Randomized Controlled Trial
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Download the PDF here
Download the PDF here
Download the PDF here
WEBCAST:
https://www.youtube.com/watch?v=Ro7svS9Deu0
Reported by Jules Levin
8th IAS Conference on HIV Pathogenesis, Treatment, and Prevention Vancouver, Canada, July 20, 2015
Myron S. Cohen representing
the HPTN 052 Study Team
from Jules: an important part of the findings of this study is that patients who started ART early achieved higher CD4 counts (see slide below) 859 vs 636, early ART was defined as starting when CD4 was 350-500. There have been many studies over recent years finding early ART is best. HHS Treatment Guidelines started recommending ART as soon as a person gets diagnosed with HIV for many reasons including it better prevents further damage to the immune system vs delaying ART, it increases chances of preventing comorbidities, decreases risk for death, decreases risk for HIV transmission as results from this study HPTN supports, and recent results reported from START Study support vary ART as well.
In The Lancet Infectious Diseases, Beatriz Grinsztejn and colleagues report the latest data from the HPTN 052 trial.6 In this study, HIV-serodiscordant couples were randomly allocated to either early initiation of HAART (ie, at a CD4 count of 350-550 cells per μL) or delayed antiretroviral treatment (ie, starting treatment when their CD4 count fell below 250 cells per μL). Fewer individuals who were assigned to early HAART had primary clinical events (57 individuals vs 77 people allocated to delayed treatment; hazard ratio 0·73, 95% CI 0·52-1·03; p=0·074), new-onset AIDS events (40 vs 61; 0·64, 0·43-0·96; p=0·031), and tuberculosis (17 vs 34; 0·49, 0·28-0·89; p=0·018). These data show a clear benefit to patients of starting HAART early, when the CD4 count is well above 400 cells per μL. The debate about the value of early HAART initiation should now be viewed as settled from both patients' and public health perspectives.
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