In Early HIV Infection, Little Reason to Delay Therapy

In a large randomized trial, half the patients who deferred therapy during early infection required treatment within 18 months.

The best approach to managing patients with recently acquired HIV infection has remained elusive. Should these patients start antiretroviral therapy (ART) immediately, regardless of CD4-cell count, or wait until they meet standard criteria? Data from a large ACTG trial of short-term ART during early infection (the Setpoint Study) provide some answers.

Adults with early (but not acute) HIV infection were randomized to a 36-week course of ART followed by treatment discontinuation or to observation only. In both groups, patients were advised to start (or restart) long-term, continuous ART if they met prespecified criteria for treatment initiation (e.g., a CD4 count <350 cells/mm³).

After 130 of a planned 150 patients had been enrolled (and 79 ha…

Reviewing Author

Paul E. Sax, MD

Disclosures

Consultant/Advisory BoardGilead Sciences; GlaxoSmithKline/ViiV; Merck; Shionogi

Grant/Research SupportNIH; Gilead Sciences; ViiV

Editorial BoardsUpToDate; Clinical Infectious Diseases

Paul E. Sax, MD

Disclosures

Consultant/Advisory BoardGilead Sciences; GlaxoSmithKline/ViiV; Merck; Shionogi

Grant/Research SupportNIH; Gilead Sciences; ViiV

Editorial BoardsUpToDate; Clinical Infectious Diseases

In Early HIV Infection, Little Reason to Delay Therapy

Topics

Reviewing Author