People with HIV should be given antiretroviral drugs as soon as they are diagnosed with the virus to significantly reduce their chances of developing AIDS and other serious illnesses, a large global study has found.
A major international randomised clinical trial found that HIV-infected individuals have a considerably lower risk of developing AIDS if they start taking antiretroviral drugs sooner, when their CD4+ T-cell count - a key measure of immune system health - is higher, instead of waiting until the CD4+ cell count drops to lower levels.
Together with data from previous studies showing that antiretroviral treatment reduced the risk of HIV transmission to uninfected sexual partners, these findings support offering treatment to everyone with HIV.
"We now have clear-cut proof that it is of significantly greater health benefit to an HIV-infected person to start antiretroviral therapy sooner rather than later," said Anthony S Fauci, Director at the National Institute of Allergy and Infectious Diseases (NIAID).
"Moreover, early therapy conveys a double benefit, not only improving the health of individuals but at the same time, by lowering their viral load, reducing the risk they will transmit HIV to others. These findings have global implications for the treatment of HIV," said Fauci.
"This is an important milestone in HIV research," said Jens Lundgren, of the University of Copenhagen and one of the co-chairs of the START study.
"We now have strong evidence that early treatment is beneficial to the HIV-positive person. These results support treating everyone irrespective of CD4+ T-cell count," said Lundgren.
The Strategic Timing of AntiRetroviral Treatment (START) study, which opened widely in March 2011, was conducted by the International Network for Strategic Initiatives in Global HIV Trials (INSIGHT) at 215 sites in 35 countries.
The trial enrolled 4,685 HIV-infected men and women ages 18 and older, with a median age of 36.
On average, participants in the study were followed for three years.
The study measured a combination of outcomes that included serious AIDS events (such as AIDS-related cancer), serious non-AIDS events (major cardiovascular, renal and liver disease and cancer), and death.
Based on data from March 2015, independent data and safety monitoring board (DSMB) found 41 instances of AIDS, serious non-AIDS events or death among those enrolled in the study's early treatment group compared to 86 events in the deferred treatment group.
The DSMB's interim analysis found risk of developing serious illness or death was reduced by 53 per cent among those in the early treatment 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.
