NIH: Early antiretroviral benefits go beyond AIDS prevention
This article was originally published in Scrip
Final results from the START study demonstrated there are a multitude of benefits with starting antiretroviral therapy early in HIV-infected patients that go beyond preventing AIDS and illnesses related to the disease, the National Institutes of Health (NIH) said on 20 July.
Indeed, the data, which were presented at the International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention in Vancouver, British Columbia in Canada, showed the drugs significantly reduced serious non-AIDS events in HIV-infected patients, including major cardiovascular, renal and liver disease, non-AIDS cancer and death not attributable to AIDS.
The risk of developing serious AIDS, serious non-AIDS or death was reduced by 57% among those in the early treatment group – regardless of age, sex, baseline CD4+ cell counts, geographic region or income level – versus those who got deferred treatment with antiretrovirals, the NIH said.
"This study conclusively shows that the benefits of early therapy far outweigh any adverse outcomes, and reinforces recommendations to offer immediate antiretroviral therapy to all patients," declared Dr Anthony Fauci, director of the NIH's National Institute of Allergy and Infectious Diseases, which provided $154m of the $166m the US government spent on conducting the START trial.
The study was undertaken to answer the question of whether HIV-infected asymptomatic patients have less risk of developing AIDS or other serious illness if they start taking ARTs sooner rather than later, based on their level of CD4+ T-cell count – a key measure of immune system health.
The trial was halted in May after preliminary data showed significant health benefits of earlier initiation of HIV treatment, regardless of the state of an individual's immune health.
START was the first large-scale randomized clinical trial to establish that all patients with HIV have a considerably lower risk of developing AIDS or other serious illnesses when they begin treatment right away after diagnosis.
The NIH noted study medications came from AbbVie, Bristol-Myers Squibb, Gilead Sciences, GlaxoSmithKline/ViiV Healthcare, Johnson & Johnson unit Janssen and Merck.