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.
The article can be found
at: Le T et al. (2013) Enhanced CD4+
T-Cell Recovery with Earlier HIV-1 Antiretroviral Therapy.
Source: Monash
University;
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