HealthDay News — Early initiation of antiretroviral therapy (ART) is associated with a sustained reduction in genetically-linked HIV-1 infections among sexual partners, according to a study published online July 18 in the New England Journal of Medicine. The research is being published to coincide with the 21st International AIDS Conference, held from July 18 to 22 in Durban, South Africa.
Myron S. Cohen, MD, from the University of North Carolina Institute for Global Health and Infectious Diseases in Chapel Hill, and colleagues randomized 1,763 index participants to receive ART at enrollment (886 participants; early-ART group) or after 2 consecutive CD4+ counts fell below 250 cells/mm³ or if an AIDS-defining illness developed (877 participants; delayed-ART group). Index participants and their partners were followed for 10,031 and 8,509 person-years, respectively.
The researchers found that there were 78 HIV-1 infections observed among partners (annual incidence, 0.9%). For 72 partners for whom viral linkage status was determined, 46 were genetically linked (3 in early-ART group and 43 in delayed-ART group) and 26 were unlinked (14 in early-ART group and 12 in delayed-ART group). The risk of linked partner infection was 93% lower with early versus delayed ART (hazard ratio, 0.07). When HIV-1 infection was stably suppressed by ART in the index participant, there were no linked infections.
“The early initiation of ART led to a sustained decrease in genetically-linked HIV-1 infections in sexual partners,” the authors write.
Study drugs were donated by various pharmaceutical companies
- Cohen MS, Chen YQ, McCauley M, et al. Antiretroviral therapy for the prevention of HIV-1 transmission. New Engl J Med. 2016; doi; 10.1056/NEJMoa1600693