Early HIV therapy pays off
Prompt treatment limits spread in study
WASHINGTON – Treating HIV right away, before patients are too sick, dramatically lowers their chances of spreading the AIDS virus to a sexual partner, says a major international study that may convince more doctors to offer medication sooner.
The nine-nation study offers convincing evidence of what scientists have long believed – that HIV medicines don’t just benefit the patient, but may act as a preventive by making those people less infectious. Earlier treatment in the study meant patients were 96 percent less likely to spread the virus to their uninfected partners, according to preliminary results announced Thursday by the National Institutes of Health, which oversaw the research.
Those findings were striking enough that the NIH said it was stopping the study four years ahead of schedule to get the word out.
When HIV patients should start taking antiviral drugs is an important question. The pills are lifesaving but also expensive – up to $15,000 a year in the U.S. – and carry a range of side effects from diarrhea to liver damage.
NIH’s Dr. Anthony Fauci said the new study promises to change practice worldwide. In developing countries, where the drugs cost a few hundred dollars a year, patients tend to be far sicker before getting medication.
Condoms remain crucial for protection – the medications don’t change that longtime recommendation. All 1,763 couples in the study, where one partner had HIV and the other didn’t, were urged to use them.
Previous research has suggested that HIV patients who use the medications are less likely to spread infection. But the $73 million study announced Thursday is the first to rigorously test that.
The couples, most of whom were heterosexual, were randomly divided. Among half, the HIV-infected partner started medication immediately after diagnosis.
In 28 couples, the uninfected person became infected by their partner. Only one of those infections occurred among the couples where the infected person was treated early, Fauci said.
The study included couples from Botswana, Brazil, India, Kenya, Malawi, South Africa, Thailand, Zimbabwe, as well as a few from the United States.