Therapy lowers risk of spreading HIV

UNC-CHAPEL HILL (US) — Treating HIV-infected individuals with antiretroviral therapy while their immune systems are still strong significantly reduces the risk of their sexual partners contracting the virus.

The findings are the first from a major randomized clinical trial to indicate that treating an HIV-infected person can make them less contagious, not just keep them healthy. The study was due to run until 2015. However, data gathered so far clearly revealed the benefits of early treatment, prompting health officials to release the results now.

“We think that these results will be important to help improve both HIV treatment and prevention and we are grateful to the study participants for their important contribution in the fight against HIV/AIDS,” says Myron Cohen, a professor of public health at the University of North Carolina at Chapel Hill.

The study, which spans nine countries, involved more than 1,700 couples, in which one partner was HIV-positive and the other was not. Each couple was randomly assigned to one of two study groups.

In the first group, the partner with HIV began receiving antiretroviral drugs as soon as they enrolled in the study; in the second group, the infected partner started antiretroviral treatment once their CD4+ count—a key measure of immune system health—fell to between 200 and 250 cells/mm3, or when they developed an AIDS-related illness. Participants in both groups received HIV primary care, counseling and condoms.

According to the available data, which was reviewed by health officials in late April of this year, 27 previously uninfected partners in the second group contracted HIV from their partner. But in the first group, only one such case of new HIV infection occurred. This means that earlier initiation of antiretroviral treatment led to a 96 percent reduction in HIV transmission between a couple.

The study was conducted by the HIV Prevention Trials Network, which is largely funded by the National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health.

“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,” says UNC professor Anthony Fauci.

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