Early, Temporary HIV Treatment Reduces Viral Load
(HealthDay News) – Treating HIV patients with antiretroviral drugs temporarily when they are first infected reduces viral load and lengthens the time off treatment, according to a study published online March 27 in PLoS Medicine.
Marlous L. Grijsen, MD, from the University of Amsterdam, and colleagues randomly assigned 168 patients with primary HIV infection (PHI) to no treatment or to combination antiretroviral therapy (cART) for 24 or 60 weeks.
The researchers found that the mean viral set point (the plasma viral load after 36 weeks without treatment) was significantly higher in untreated patients, with 4.8 log10 copies/mL for no treatment, 4 for 24 weeks of cART, and 4.3 for 60 weeks of cART. The median total time before starting or restarting cART (due to CD4 counts falling <350 cells/mm³ or symptomatic HIV disease) was significantly shorter in untreated patients, at 0.7 years compared with 3 years for 24 weeks of cART and 1.8 for 60 weeks of cART. After adjusting for possible confounders, 24 and 60 weeks of early treatment correlated with time to restart of cART (hazard ratios, 0.42 and 0.55, respectively).
"In conclusion, this randomized study demonstrates a clear clinical benefit of temporary cART initiated during PHI," Grijsen and colleagues write. "Although extended follow-up studies are needed to evaluate the long-term benefits of such early treatment, starting cART when the patient is ready to do so seems the most reasonable advice for patients with PHI."