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Data favor immediate vs. deferred ART in patients recently infected with HIV-1
Hogan CM. J Infect Dis. 2012;205:87-96.
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A limited period of antiretroviral therapy during early HIV-1 infection moderately delayed the need for subsequent treatment, according to findings published in The Journal of Infectious Diseases.
In February 2005, the 96-week open-label AIDS Clinical Trials Group (ACTG) Setpoint Study (A5217) was initiated across 25 sites in the United States and across two sites in Peru.
Christine M. Hogan, MD, of the Medical College of Wisconsin, and colleagues randomly assigned 150 patients aged 18 years and older within 6 months of HIV-1 seroconversion to 36 weeks of antiretroviral treatment followed by discontinuation in the immediate treatment group or to receive no treatment in the deferred treatment group until prespecified criteria for initiation of therapy were met.
Virologic outcomes were then compared among both groups.
The researchers said the immediate treatment group showed better outcomes at week 72 vs. the deferred treatment group (P=.005) and the deferred treatment group at week 36 (P=.002).
Compared with a 10% progression to ART in the immediate treatment group, the deferred treatment group experienced a 50% progression. The researchers said progression to ART initiation in the deferred treatment group occurred at a higher rate than expected, and the ability to evaluate virologic set point was limited; therefore, the study was discontinued by the Data Safety Monitoring Board in June 2009.
Disclosure: This work was supported by the National Institute of Allergy and Infectious Diseases (U01AI068636), the National Institute of Mental Health and the National Institute of Dental and Craniofacial Research.
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