IAS 2015: START Trial Provides Definitive Evidence of Benefits of Early HIV Treatment (Dr. Julio Montaner)
People who start antiretroviral therapy (ART) immediately after an HIV diagnosis — while their CD4 T-cell count is still high — rather than waiting until it falls below 350 cells/mm3 have a significantly lower risk of illness and death, according to long-awaited findings from the START trial presented at the 8th International AIDS Society Conference this week in Vancouver and published simultaneously in the July 20 advance edition of the New England Journal of Medicine.
Jens Lundgren from the University of Copenhagen reported that 1.8% of study participants in the immediate treatment group experienced a combined endpoint of serious AIDS-related events, serious non-AIDS events, and death compared with 4.1% in the deferred therapy group — a 57% reduction. The most common events in both study arms were tuberculosis (TB) and cancer.
“IAS 2015 will be remembered as the definitive moment when the world agreed earlier initiation of treatment is the best way to preserve the health of people living with HIV, and one of the best tools we have to slow HIV transmission to others,” said conference co-chair Julio Montaner of the British Columbia Centre for Excellence in HIV/AIDS. “The new data presented today will inform HIV treatment guidelines worldwide, and inspire governments, funders and health systems to act to save millions more lives.”
Liz Highleyman reports.