'Early treatment' breakthrough in HIV research

Early antiretroviral therapy reduces HIV transmission by 96%, the University of the Witwatersrand (Wits) in Johannesburg announced on Thursday, following a multi-centre study.

The university said the international clinical trial, which included Wits researchers, found that early treatment with antiretrovirals (ARVs) was “highly effective” in reducing transmission between infected and uninfected partners.

“The results are an extremely important breakthrough in the field of HIV prevention and conclusively demonstrate that treatment of the HIV-infected person reduces the chance they will transmit HIV to their negative partner,” Dr Guy de Bruyn, a principal investigator for the study, said in a statement.

Another principal investigator Professor Ian Sanne said the study found that early ARV treatment also reduced the incidence of tuberculosis in HIV infected patients by 40%.

In addition, the study showed it was safe to take ARVs when CD4+ counts were high, earlier on in the syndrome.

The CD4+ count is a determinant of how well the immune system works in a person diagnosed with HIV.

“The results suggest that HIV-infected patients will benefit from taking ARVs when their CD4 levels are between 350 and 550, both protecting their HIV negative partners and improving their own health,” Sanne said.

In South Africa, the study was conducted at the perinatal HIV research unit, based at the Chris Hani-Baragwanath Hospital, in Soweto, and at the Helen Joseph Hospital, in Westdene, Johannesburg.

The study involved more than 1 763 couples in Africa, Asia and North and South America.

“All study participants received a comprehensive package of prevention services designed to reduce their risk of HIV infection throughout the trial, including HIV-testing, intensive safer-sex counselling, provision of free condoms and treatment of sexually-transmitted infections,” the university said.

It said half of the HIV-infected study participants received ARVs before standard guidelines indicated they should.

The other half received ARVs as indicated by World Health Organisation (WHO) guidelines.

“In all, 28 linked infections occurred in couples participating in the study,” the university said.

Only one of these infections was in a couple where the HIV-infected partner received early treatment.

A further 11 infections occurred and were either not linked or the investigations had not been finalised.

Professor Glenda Gray, from the Wits perinatal HIV research unit, said interventions which benefited both HIV-infected people and their partners were needed in countries like South Africa, “where there is a high burden of HIV in communities”.—Sapa

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