HIV Treatment for All Is Perhaps the Key to Ending the Epidemic

Experts have long assumed that effective HIV treatment, like that of most infectious diseases, has a double role: restoring health and limiting contagion.

Investigators randomized 1763 healthy HIV-positive people who were part of a serodiscordant couple (i.e., the steady sexual partner was HIV-negative) to begin combination antiretroviral treatment immediately or to wait until CD4-cell counts had declined to the levels that usually prompt treatment initiation. Participants were enrolled in nine countries, including the U.S.; 54% were in Africa; nearly all were heterosexual; 50% were men; and all were relatively immunologically intact, with CD4-cell counts between 350 and 550 mm³.

After a median follow-up of 1.7 years, plasma HIV levels were s…