U study recommends earlier HIV treatment

U study recommends earlier HIV treatment

Ellen Schmidt

A University of Minnesota-led HIV study could change the way world health leaders treat the disease by instructing them to do so sooner.
 
Though researchers planned to continue the study for at least another year, it was cut short when investigators found that more than half of HIV-infected participants showed significant improvement in AIDS-related symptoms when they were treated with antiretroviral medication upon diagnosis, according to an announcement from the National Institutes of Health released late last month. Traditionally, treatment procedures start after a patient’s infection has progressed.
 
To support their arguments, recommendations to the World Health Organization and the U.S. government will draw on the findings, which are set to be published mid-summer.
 
The study, which received funding from the NIH, reported better immunity in patients if they received treatment when diagnosed with HIV, regardless of the patient’s CD4+ cell count — a measure of immune health. In the past, treatment of the disease began only after cell counts dropped below 350, said James Neaton, who is lead investigator of the study and a University biostatistics professor.
 
Though there is no international policy that regulates when treatment begins, the data — which will be presented at a WHO conference in July — could motivate officials to create protocols.
 
“The whole purpose of the research is to drive policy in the U.S. and globally,” said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious 
Diseases.
 
However, Fauci said finding the necessary resources in developing countries could be a roadblock in moving forward with the change internationally. 
 
“The subtext of all this is that they may not have the resources,” he said. “We’re hoping that the solidity of the science is going to get them to have the resources to implement this program.”
 
The study’s subjects stretched across 35 countries and included about 5,000 enrollees. The Hennepin County Medical Center served as the Minneapolis home base for the $156 million study.
 
Starting treatment early has a greater effect than upping immune health. Previous studies have shown that early antiretroviral treatment can also reduce the 
transmission of HIV. 
 
“This makes what we’re doing even more important,” Neaton said. “If we can show that this treatment is safe for people with much higher CD4+ cell counts, this could have major public  health importance, and that was the case.”
 
Students from the University’s Sexual Health Awareness and Disease Education student group say the findings suggest students should undergo consistent testing for sexually transmitted diseases. SHADE works to educate students about safe sex and provides free STD testing.
 
“I think [the study] is a great reason for college students to get in the habit of regular [STD] testing early and to maintain that habit,” said nursing senior and SHADE member Anna Revolinski. “That way we can catch these HIV infections early and reduce risk of transmission and then also reduce any long-term health effects of the virus.”
 
The next steps for Neaton’s team are to publish the study. Because of the convincing results, he said, the team won’t be continuing to research the topic.
 
“We answered the question,” Neaton said.