Are there benefits to starting antiretroviral therapy during primary HIV infection? Conclusions from the Seattle Primary Infection Cohort vary by control group.

International Journal of STD & AIDS
Joanne SteklerAnn C Collier

Abstract

It is controversial whether starting combination antiretroviral therapy (cART) during primary HIV infection (PHI) is beneficial. Subjects in this observational cohort began cART <30 days (group 1: acute treatment, n = 40), 31-180 days (group 2: early treatment, n = 82) or >180 days (group 3: delayed treatment, n = 35) after HIV infection, and were compared with 27 historical and 60 contemporary controls. Time to HIV-related diagnoses did not differ for group 1 (adjusted hazard ratio [aHR] 1.44, P = 0.3) or group 2 (aHR 1.17, P = 0.5) compared with contemporary controls, but it was delayed for both treated groups (aHR 0.38 for group 1, P = 0.01; and aHR 0.28 for group 2, P < 0.0001) compared with historical controls. Although rates of HIV-related diagnoses were similar in acutely treated subjects and contemporary controls, results were confounded by associations between higher CD4 counts, lower HIV RNA levels and delayed disease progression as reasons for deferring treatment. Randomized trials are needed to address benefits of cART during PHI.

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Citations

Jan 18, 2016·Journal of Clinical Virology : the Official Publication of the Pan American Society for Clinical Virology·Joanne D SteklerMatthew R Golden
Oct 29, 2013·Enfermedades infecciosas y microbiología clínica·UNKNOWN Panel de expertos de GeSIDA y Plan Nacional sobre el Sida
Dec 18, 2013·Journal of Clinical Virology : the Official Publication of the Pan American Society for Clinical Virology·Joanne D SteklerBernard M Branson
May 15, 2018·AIDS Research and Human Retroviruses·Joanne D SteklerAnn C Collier
Apr 18, 2014·Indian Journal of Pathology & Microbiology·Gunasekera Henadira Appuhamilage Kamani MangalikaAbeygunasekera Nalaka
Oct 29, 2014·The Journal of Immunology : Official Journal of the American Association of Immunologists·Tsuyoshi FujitaLishomwa C Ndhlovu
Nov 15, 2017·Journal of Gerontological Social Work·Lesley M HarrisCharles Furlotte
Aug 10, 2019·Frontiers in Immunology·Behzad EtemadJonathan Z Li

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