Anti-HIV medications suppress the viral load of people living with HIV and provide durable protection against heterosexual transmission, a new study suggests.
The findings, which show a 93 percent reduction of HIV transmission when the infected person started antiretroviral therapy or ART at a higher CD4 cell count, appear in the New England Journal of Medicine.
“The HPTN 052 study confirms the urgent need to treat people with HIV infection as soon as infection is diagnosed to protect their health and for public health,” says Myron S. Cohen, director of the Institute for Global Health and Infectious Diseases at the University of North Carolina at Chapel Hill. “This study represents more than a decade of effort by a worldwide team of investigators, and the tremendous courage and generosity of more than 3,500 clinical trial participants.”
Worldwide, 37 million people are living with HIV. HPTN 052 began in 2005 and enrolled 1,763 HIV-serodiscordant couples—where one person was living with HIV and the other was not—at 13 sites in nine countries (Botswana, Brazil, India, Kenya, Malawi, South Africa, Thailand, the United States, and Zimbabwe).
Ninety-seven percent of the couples were heterosexual. HIV-infected participants were assigned at random to start ART at the beginning of the study when their immune system was relatively healthy (called the “early” arm), or later in the study when they had immune system decline (called the “delayed” arm).
In 2011, interim study results showed significant benefit of early ART, with a 96 percent reduction in HIV transmission from early ART compared to delayed ART.
All HIV-infected participants in the study were then offered ART and the study was continued until May 2015 to understand the magnitude and durability of “treatment as prevention”; 87 percent of the HIV-infected participants remained in the study for its 10-year duration.
Researchers say the HPTN 052 results have helped to galvanize a worldwide commitment to a universal “treatment as prevention” strategy for combating the HIV/AIDS epidemic, with ART offered to all HIV-infected people, regardless of CD4 cell count.
Source: UNC-Chapel Hill