Treatment for HIV Should Start within Four Months of Infection
January 17, 2013 (SAN DIEGO) - Today, the New England Journal of Medicine published, "Enhanced CD4+ T-Cell Recovery with Earlier HIV-1 Antiretroviral Therapy," suggesting the optimal time for initiating antiretrovial therapy (ART) is within four months after HIV infection.
UC San Diego AntiViral Research Center researchers Susan Little, MD, Douglas Richman, MD, Davey Smith, MD and Jason Young, PhD co-authored the paper that sought to determine the relationship between the timing of the initiation of ART after infection with HIV and the recovery of CD4+ T-cell counts.
HIV researchers and clinicians have long known the overall benefit of starting ART early in the progression of HIV infection. Until now, though, the optimum window period for beginning ART to aid in CD4+ recovery was unknown.
"The thing that we didn't already suspect," Little explained in an interview with KPBS, "is that that restorative time window was so short."
This short restorative time window, has severe implications for HIV testing.
The HIV rapid tests most often used in community health clinics identify HIV antibodies to the virus and may take anywhere from three to six months to be detectable. An HIV infection identified using a rapid test has already progressed at least three months, cutting well into the optimum four-month window for initiating ART.
Fortunately, specialized nucleic acid tests like UCSD's The Early Test detect parts of HIV, instead of the antibodies to the virus. These HIV nucleic acids can be detected in the blood as early as one week after exposure to the virus, drastically improving how soon a new HIV infection can be diagnosed. More importantly, it provides an newly-infected HIV patient the opportunity to begin ART within the optimum four-month window.
Little and her colleagues are optimistic that the findings of their research will encourage HIV testing sites serving communities at high risk for HIV infection to provide nucleic acid testing as a means for early diagnosis and treatment of HIV.
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