Breakthrough: Early ARV treatment protects partners from HIV, new study confirms

The HIV Prevention Trials Network conducted this research in 9 countries with 1763 serodiscordant couples

HIV doctors, scientists and activists are not surprised at the results of a major clinical trial that has found early antiretroviral therapy hugely reduces HIV transmission.

“This breakthrough is a serious game changer and will drive the prevention revolution forward. It makes HIV treatment a new priority prevention option,” said Michel Sidibé, Executive Director of the Joint United Nations Programme on HIV/AIDS (UNAIDS).

“Now we need to make sure that couples have the option to choose Treatment for Prevention and have access to it.”

The results of the trial are good, so good in fact that the researchers have suspended the study four years ahead of schedule to allow all participants and their sexual partners to benefit from early treatment.

“The study (HPTN 052) was designed to evaluate whether antiretroviral drugs can prevent sexual transmission of HIV infection among couples in which one partner is HIV-infected and the other is not. The results are the first of their kind from a major randomized clinical trial,” according to the lead researcher Dr Myron Cohen from the University of North Carolina.

“The research found that treating HIV-infected individuals with antiretroviral therapy (ART) when their immune systems are still relatively healthy led to a 96 percent reduction in HIV transmission to their partners.

“This critical new finding convincingly demonstrates that early treatment of infected individuals can have a major impact on the spread of the epidemic.”

Of the 1763 couples from nine countries who volunteered for the study, only one new infection took place among the couples in the “immediate treatment” group.

This contrasts significantly to the 27 infections that took place in the group who waited until a later stage of the disease – as the current guidelines recommend – to start ARVs.

The new HIV infections were linked through genetic analysis to the infected partners in the study.

“This breakthrough is a serious game changer and will drive the prevention revolution forward. It makes HIV treatment a new priority prevention option,” said Michel Sidibé, Executive Director of the Joint United Nations Programme on HIV/AIDS (UNAIDS).

“Now we need to make sure that couples have the option to choose Treatment for Prevention and have access to it.”

South Africa, Kenya, Thailand, India, Brazil, Botswana, Malawi and Zimbabwe were the countries involved in the trial.

Early ARV therapy also helped prevent a type of TB found outside the lungs.

“HPTN 052 shows a prevention benefit that must be translated into programmatic reality. If deployed effectively, efficiently and ethically, early initiation of treatment will be fundamental to turning the tide of the epidemic,” says Mitchell Warren, executive director of AVAC: Global Advocacy for HIV Prevention.

The HIV Prevention Trials Network – largely funded by the National Institute of Allergy and Infectious Diseases (NIAID) – conducted the trial.