Heterosexual HIV-Serodiscordant Couples Greatly Benefit from Early ART

Researchers from the University of North Carolina (UNC) at Chapel Hill Health Care and School of Medicine are describing results from a human immunodeficiency virus (HIV) study as groundbreaking.

The HIV Prevention Trials Network (HPTN) 052 study began in 2005 and focused on 1,763 HIV-serodiscordant couples — meaning that only one partner was infected. The participants were gathered from nine countries, including the United States, Botswana, Brazil, India, Kenya, Malawi, South Africa, Thailand, and Zimbabwe. The aim was to identify infection rates within the couples using early or delayed antiretroviral therapy (ART).

Many HIV studies focus on men who have sex with men, but HPTN 052 consisted of 97% heterosexual couples.

“This study represents more than a decade of effort by a worldwide team of investigators, and the tremendous courage and generosity of more than 3,500 clinical trial participants,” principal investigator Myron S. Cohen, MD, director of the UNC Institute for Global Health and Infectious Diseases, said in a news release.

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The researchers randomly assigned the patients with HIV to either receive early or delayed ART. The 886 patients who started treatment early had CD4+ counts of 350 to 550 cells per cubic millimeter. The other 877 patients began ART after two consecutive CD4+ counts that were below 250 cells per cubic millimeter — or if they developed an acquired immunodeficiency syndrome (AIDS) illness.

A total of 78 partners became infected with HIV-1 during the study, according to the report in The New England Journal of Medicine. Of those, 72 partners’ viral-linkage status was identified — 46 of which were linked and 26 were unlinked. For the 46 people who were linked, 43 were partners of a participant in the delayed ART group.

Receiving early ART was connected with a 93% lower risk of linked partner infection when compared to the delayed treatment group.

“The HPTN 052 study confirms the urgent need to treat people with HIV infection as soon as infection is diagnosed to protect their health and for public health,” Cohen concluded.

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