New study finds earlier treatment is beneficial

Those affected by HIV stand a “considerably lower risk” of developing AIDS or other serious illnesses if antiretroviral drugs are administered earlier, according to a new study conducted by the International Network for Strategic Initiatives in Global HIV Trials – INSIGHT.

The START – Strategic Timing of Antiretroviral Treatment – trial is the first large scale randomised clinical trial to figure out if taking HIV medication earlier than currently recommended is beneficial.
At the moment, the World Health Organisation HIV treatment guidelines recommend that people infected with HIV begin antiretroviral therapy when their CD4+ cell count – white blood cells – drop to 500 cells/mm3 or less.
The new trial is “clear cut proof” according to NIAID – National Institute of Allergy and Infectious Diseases – Director Anthony S. Fauci, that starting treatment regardless of white blood cell count per mm3, is massively beneficial.
During the study, people were randomised and put into one of two groups. One group were given treatment when their CD4 count was above 500, and the other waited until their count was below 350.
According to Ibase, one of the biggest surprises was that even at very high CD4 counts, treatment was shown to reduce the risk of AIDS and other serious illnesses.
Jens Lundgren, M.D., of the University of Copenhagen said: “This is an important milestone in HIV research. These results support treating people irrespective of CD4+ T-cell count.”
Dr Rosemary Gillespie, Chief Executive at Terrence Higgins Trust, said on the study:
“This ground-breaking research adds to the growing body of evidence that shows there should be no delay in starting HIV treatment. Early diagnosis and treatment mean that people living with HIV can expect to live long and healthy lives, and can also reduce the chances of HIV being passed on unwittingly. They are key tools in our efforts to stop the spread of HIV in the UK
The results have been released earlier than expected. They were due to be concluded in 2016 – the trial will still continue until then – after having started in 2011; however the Data and Safety Monitoring Board found on 13 May this year that the results were so clear that they recommended the study be changed and all participants now have the option to change to the early treatment.
Until now, large database tests had not managed to find benefits of starting treatment early and because the START study was randomised, it makes the results very unlikely to be by chance.
The findings are ground breaking and a massive help for those affected by HIV.
More detailed results from the study are expected to be released at the International AIDS Conference in Vancouver in July.
Words Paul Greenough, @paulsgreenough