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Initiation of antiretroviral therapy in HIV-infected adults at CD4 counts >350 cells/mm³ significantly reduced the incidence of clinical events and is cost-effective, according to two analyses presented at AIDS 2012.

The HPTN 052 study was a randomized trial to determine if early treatment of HIV infection decreased the probability of transmission. HIV-infected adults with CD4 counts between 350 and 550 cells/mm³ who were part of serodiscordant heterosexual couples were randomized to either start antiretroviral therapy (ART) immediately or wait until their CD4 counts dropped below 250 cells/mm³ or they developed an AIDS-defining event. The primary results of the study were published last year and conclusively demonstrated that “treatment is prevention” (JW AIDS Clin Care Jul 19 2011). Now, in two late-breaker abstracts presented at AIDS 2012, the HPTN 052 team has shown that early treatment also benefits the individual and is cost-effective.

In the first…

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Carlos del Rio, MD

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