A recent study evaluated whether taking HIV medications early would benefit an HIV-positive person and help stop the transmission of HIV to their non-infected partner.
The study, conducted in 13 countries, enrolled 1,763 couples in which one person in the relationship was HIV-positive and the other was HIV-negative.
It was concluded that HIV-positive people who took antiretroviral therapy (ART) reduced their risk of transmitting the virus to their partners by 96%, compared with those who did not immediately start treatment. Antiretroviral drugs work by lowering the ‘viral load’ – the amount of HIV in the body.
The study was so successful that it was stopped four years before it was scheduled to end.
Current U.S. treatment guidelines call for antiretroviral treatment to begin when a patient’s CD4 count falls below 500, while most international guidelines require waiting until it drops below 350. Participants in the study had CD4 counts between 350 and 550 at the beginning of the study.
Examinations of the results last month found 39 new HIV infections. Twenty-eight of the infections clearly came from the person’s partner, based on genetic analysis of the virus; seven were thought to have arisen from other sources; and four probably came from other sources but researchers were not sure.
Among the 28 who developed new infections that clearly seemed to come from their partners, 27 were in the group in which treatment with antiretroviral drugs was deferred.
There were 23 deaths in the study, 10 in the immediate-treatment group and 13 in the delayed ART group. The difference was not ‘statistically significant’, and the researchers have not yet analyzed the causes.
Although this study clearly points to new possibilities for prevention through early antiretroviral therapy, the findings cannot be stated as being applicable to gay men as 97% of those enrolled were heterosexual, with 873 women and 890 men participating.