Breaking news: what do the START results mean for HIV positive people

A major international randomized clinical trial has found that HIV-infected individuals have a considerably lower risk of developing AIDS or other serious illnesses if they start taking antiretroviral drugs sooner, when their CD4+ T-cell count—a key measure of immune system health—is higher, instead of waiting until the CD4+ cell count drops to lower levels. Together with data from previous studies showing that antiretroviral treatment reduced the risk of HIV transmission to uninfected sexual partners, these findings support offering treatment to everyone with HIV.

The new finding is from the Strategic Timing of AntiRetroviral Treatment (START) study, the first large-scale randomized clinical trial to establish that earlier antiretroviral treatment benefits all HIV-infected individuals. The National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, provided primary funding for the START trial. Though the study was expected to conclude at the end of 2016, an interim review of the study data by an independent data and safety monitoring board (DSMB) recommended that results be released early.

“We now have clear-cut proof that it is of significantly greater health benefit to an HIV-infected person to start antiretroviral therapy sooner rather than later,” said NIAID Director Anthony S. Fauci, M.D. “Moreover, early therapy conveys a double benefit, not only improving the health of individuals but at the same time, by lowering their viral load, reducing the risk they will transmit HIV to others. These findings have global implications for the treatment of HIV.”

For an easy to read explanation of the START Study go to the article written by Simon Collins on the i-Base web site at i-base.info/breaking-news-w...

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  • As much as I would like to say that this is great news overall, I am not convinced that is 'true' for everyone.

    My CD4, in 1985 when I was first diagnosed was by todays standards low - very low. Understandly the prognosis then wasnt at all good. No treatment options, nothing! Just a handful of 'Clap Clinic' doctors with an interest in the new 'gay plague', who were just as mystified and for many friends the last or only face they saw, albeit wrapped in a surgical mask behind a plastic isolation tent in a stark hospital side room - away from everyone and prying eyes (including staff) and random visitors. Tirelessly, these doctors became the trialists of new antiretroviral drugs on willing participants such as myself. For every one we have heard of there were many that didnt quite make the shelves.

    AZT changed the playing field. It was the 1st drug licensed as treatment and was my introduction. I seem to remember that it was prohibitively expensive (about £15000) a year to prescribe and some hospitals wouldnt offer it. I was lucky. I was luckier as it worked for me, the numbers started to slowly get better.

    This is where I start to wonder. Over the years ther have been many who have questioned long periods of treatment and others who advocate it. There is also the question of cost. Which also equates to profit. Granted, the costs involved of bringing a new drug to market are huge but do the maths. If everyone sexually active is taking a regime of medication pre and post exposure...

    Please dont get me wrong, I am not saying that there is an upper limit to the cost of HIV prevention, cure or care but I do worry that it is becoming unaffordable for large sections of the planet, without the benefit of our NHS or medical insurance elsewhere. Likewise, should the GSKs and Pffizers of this World be collectings hundreds of thousands of pounds from each of us throughout our 50,60 plus years of sexual activity? Firms who do pay into this reasearch and subsequent trials.

    Vent of steam over!

    It just annoys me when we are told that it is for our benefit! Yes, that is not an incorrect statement in itself - its just not all the story.

    Ian