Early antiretroviral therapy avoids AIDS outcomes for HIV-infected people
The Strategic Timing of AntiRetroviral Treatment (START) study is the first large-scale, randomized clinical trial that demonstrates early antiretroviral treatments are beneficial to all people with HIV infections. According to the study, the therapies significantly reduced non-AIDS-related illnesses as well as serious AIDS-related diseases.
"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," National Institute of Allergy and Infectious Diseases Director Anthony S. Fauci said. "Today's findings show that early antiretroviral treatment presents no additional risk of serious, non-AIDS-related disease to people taking treatment, but actually confers valuable protection against these illnesses, helping keep HIV-infected people healthier longer."
James D. Neaton, INSIGHT principal investigator and a professor of biostatistics at the University of Minnesota, said the comprehensive evaluation of the risks and benefits of early treatment in START provides policymakers, clinicians and HIV-positive individuals a strong set of data to inform antiretroviral therapy initiation policies.
Jens Lundgren, of the University of Copenhagen and one of the co-chairs of the START study, said the results show that early treatment not only reduces opportunistic infections, which offers a bigger benefit in lower-income countries, but also prevents a significant amount of illness in higher-income countries as well by reducing the risk of serious non-AIDS events that consisted largely of cancer and cardiovascular disease.
"Further follow-up of this relatively young study population may help us better understand how early antiretroviral therapy impacts the cardiovascular system," Fred M. Gordin, study co-chair and Chief of Infectious Diseases at the Veterans Affairs Medical Center in Washington, D.C., said. "While this study was long enough for us to gather important evidence on starting therapy early, three years is a relatively short time period compared to lifelong antiretroviral therapy."