Sunday, March 17, 2013

USA – Australia - Early HIV Therapy Crucial For Success, Study

New insight into the optimal window of therapy for HIV infection shows that treatments initiated within four months of infection leads to better treatment outcomes.

New insight into the optimal window of therapy for HIV infection could give patients a better chance of responding to treatments.

A new U.S. and Australian study has found that antiretroviral therapy (ART) initiated within four months of HIV infection leads to a stronger and faster recovery of the body’s CD4+ T-cells than patients who started therapy later.

CD4+ T-cells are specialized immune cells required to fight infections and are depleted during HIV infection.

The study, published in The New England Journal of Medicine, was co-authored by Monash University’s Associate Professor Edwina Wright with physicians from The University of Texas and the University of California, and drew data of 468 patients followed over a 48-month period in the San Diego Primary Infection Cohort.

“In the four months after HIV infection the immune system mounts an immune response and starts to recover naturally before it subsequently progressively declines. This observation tells us that there may be a narrow restorative window that could be targeted for recovery through earlier initiation of potent antiretroviral therapy,” Wright said.

“Through early therapy, full recovery of the CD4+ T-cell count could make a critical difference to the immune system’s overall health and the individuals capacity to directly fight off infections, tumors, and disease. This knowledge may also better position them to be successful if any HIV curatives come along,” she said.

According to Wright, even a short deferral of antiretroviral therapy outside of the four-month window could compromise CD4+ T-cell recovery, irrespective of the CD4+ count at the time of treatment initiation.

Further clinical studies are needed to determine whether starting antiretroviral therapy earlier could enhance the chance of patients responding to future cure strategies, she said.

Wright and colleagues at Monash University are also involved in a major new clinical trial, the START study, designed to look at the benefits of immediate versus deferred antiretroviral treatment in people with HIV infection.

The trial is being conducted in 30 countries and will recruit 4,000 HIV-infected men and women. Participants will be followed for up to five years.

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