Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Study suggests early ART in recently HIV-infected patients preferable to delayed treatment

16.12.2011
Among people recently infected with HIV, immediate antiretroviral therapy (ART) appears preferable to deferring treatment, according to a new study published in the Journal of Infectious Diseases and now available online. Although the benefits of ART during early HIV-1 infection remain unproven, the findings support growing evidence favoring earlier ART initiation.

Christine Hogan, MD, of the Medical College of Wisconsin in Milwaukee, led a team of researchers from various institutions to investigate the effects of ART on individuals infected with HIV-1 within the previous six months.

The multicenter clinical trial—the AIDS Clinical Trials Group (ACTG) Setpoint Study—enrolled 130 men and non-pregnant women who were at least 18 years old and had not received ART previously. Participants were randomized into two groups: In the immediate treatment group, patients were to receive ART treatment for 36 weeks, after which treatment was stopped; treatment was deferred for patients in the second group. All individuals were followed throughout the study.

The study's primary endpoint was the patients' virologic setpoint at 72 weeks. The researchers also sought to compare the virologic setpoint at 72 weeks for patients in the immediate treatment group with that of patients in the deferred treatment group at 36 weeks.

Investigators found that the immediate treatment group had a better outcome than the deferred group. Individuals in the deferred arm experienced higher than anticipated rates of disease progression, necessitating the start of HIV treatment before the study endpoint. Half of the participants in the deferred treatment group required treatment on medical grounds within 18 months.

According to Dr. Hogan and colleagues, the results suggest that "if immediate therapy is not begun, progression to meeting standard criteria for ART initiation may occur more rapidly than expected, especially with changing treatment paradigms." In addition, patients who received treatment immediately appear to have been protected not only during treatment but for a brief period of time afterward.

In an accompanying editorial, Harout Tossonian, MD, PhD, and Brian Conway, MD, of the University of British Columbia in Vancouver, Canada, noted that "immune preservation and reduction in the latent pool of HIV-1-carrying CD4 T-cells seems to require intervention at the earliest possible time of acute infection." They noted that the advantages of immediate treatment appear to be achieved with little to no harm to the patient, either in terms of drug-related toxicity or emergence of drug resistance. "The initial course of 36 weeks of treatment may delay the need for re-starting it more than the 36 weeks spent on it from the time of initial presentation," Drs. Tossonian and Conway wrote. "Thus over the lifetime of the patient, there will be less cumulative drug exposure."

Dr. Hogan and her team suggest that the findings may be of interest to clinicians and patients struggling with when to begin ART. An additional sub-study is underway "to address whether immediate versus deferred treatment during primary HIV infection results in improvements in markers of inflammation and immune activation, which may provide further insight into potential benefits of treating primary infection," the authors wrote.

Fast Facts:

1) In a comparative randomized trial of immediate versus deferred antiretroviral therapy (ART) in early HIV infection, patients whose therapy was deferred experienced higher than anticipated rates of disease progression.

2) Participants who received treatment immediately appear to have been protected not only during treatment but also for a brief period of time after treatment was stopped.

The study and the accompanying editorial are available online. They are embargoed until 12:01 a.m. EST on Friday, Dec. 16, 2011:

The Setpoint Study (ACTG A5217): Effect of Immediate Versus Deferred Antiretroviral Therapy on Virologic Set Point in Recently HIV-1–Infected Individuals

Recent HIV-1 Infection: To Treat or Not to Treat, That Is the Question

Published continuously since 1904, the Journal of Infectious Diseases is the premier global journal for original research on infectious diseases. The editors welcome major articles and brief reports describing research results on microbiology, immunology, epidemiology, and related disciplines, on the pathogenesis, diagnosis, and treatment of infectious diseases; on the microbes that cause them; and on disorders of host immune responses. The journal is an official publication of the Infectious Diseases Society of America (IDSA). Based in Arlington, Va., IDSA is a professional society representing more than 9,000 physicians and scientists who specialize in infectious diseases. For more information, visit http://www.idsociety.org.

John Heys | EurekAlert!
Further information:
http://www.idsociety.org

More articles from Studies and Analyses:

nachricht Physics of bubbles could explain language patterns
25.07.2017 | University of Portsmouth

nachricht Obstructing the ‘inner eye’
07.07.2017 | Friedrich-Schiller-Universität Jena

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Carbon Nanotubes Turn Electrical Current into Light-emitting Quasi-particles

Strong light-matter coupling in these semiconducting tubes may hold the key to electrically pumped lasers

Light-matter quasi-particles can be generated electrically in semiconducting carbon nanotubes. Material scientists and physicists from Heidelberg University...

Im Focus: Flexible proximity sensor creates smart surfaces

Fraunhofer IPA has developed a proximity sensor made from silicone and carbon nanotubes (CNT) which detects objects and determines their position. The materials and printing process used mean that the sensor is extremely flexible, economical and can be used for large surfaces. Industry and research partners can use and further develop this innovation straight away.

At first glance, the proximity sensor appears to be nothing special: a thin, elastic layer of silicone onto which black square surfaces are printed, but these...

Im Focus: 3-D scanning with water

3-D shape acquisition using water displacement as the shape sensor for the reconstruction of complex objects

A global team of computer scientists and engineers have developed an innovative technique that more completely reconstructs challenging 3D objects. An ancient...

Im Focus: Manipulating Electron Spins Without Loss of Information

Physicists have developed a new technique that uses electrical voltages to control the electron spin on a chip. The newly-developed method provides protection from spin decay, meaning that the contained information can be maintained and transmitted over comparatively large distances, as has been demonstrated by a team from the University of Basel’s Department of Physics and the Swiss Nanoscience Institute. The results have been published in Physical Review X.

For several years, researchers have been trying to use the spin of an electron to store and transmit information. The spin of each electron is always coupled...

Im Focus: The proton precisely weighted

What is the mass of a proton? Scientists from Germany and Japan successfully did an important step towards the most exact knowledge of this fundamental constant. By means of precision measurements on a single proton, they could improve the precision by a factor of three and also correct the existing value.

To determine the mass of a single proton still more accurate – a group of physicists led by Klaus Blaum and Sven Sturm of the Max Planck Institute for Nuclear...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Closing the Sustainability Circle: Protection of Food with Biobased Materials

21.07.2017 | Event News

»We are bringing Additive Manufacturing to SMEs«

19.07.2017 | Event News

The technology with a feel for feelings

12.07.2017 | Event News

 
Latest News

NASA mission surfs through waves in space to understand space weather

25.07.2017 | Physics and Astronomy

Strength of tectonic plates may explain shape of the Tibetan Plateau, study finds

25.07.2017 | Earth Sciences

The dense vessel network regulates formation of thrombocytes in the bone marrow

25.07.2017 | Life Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>