Starting anti-retroviral treatment early improves outcomes for HIV+ people: Study

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The National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, provided primary funding for the START trial. “We now have proof that it is of significantly greater health benefit to an HIV-infected person to start anti-retroviral therapy sooner than later,” said NIAID director Anthony S Fauci.

Early therapy conveys a double benefit – not only to improve the health of individuals but at the same time by lowering their viral load, reducing the risk of HIV transmission. These findings have global implications for the treatment of HIV, Pujari told The Indian Express.
The START study, which opened widely in March 2011, was conducted by the International Network for Strategic Initiatives in Global HIV Trials (INSIGHT) at 215 cities in 35 countries. As many as 4,685 HIV-infected men and women, aged 18 and older, with a median age of 36 were enrolled for the trial. Participants had never taken anti-retroviral therapy and were enrolled with CD4+ cell counts in the normal range-above 500 cells per cubic millimetre (cells/mm3).

Approximately half of the participants were randomised to initiate anti-retroviral treatment immediately (early treatment), and the other half were randomised to defer treatment until their CD4+ cell count declined to 350 cells/mm3. On an average, participants in the study were followed for three years.

The interim analysis found risk of developing serious illness or that death was reduced by 53 per cent among those in the early treatment group, compared to those in the deferred group. Rates of serious AIDS-related events and serious non AIDS-related events were both lower in the early treatment group than the deferred treatment group.