Understanding the Benefits of Antiretroviral Therapy for HIV Protection

"ART treatment is exceptionally good at stopping transmission," said Myron Cohen, MD, Department of Infectious Disease, UNC.

Myron Cohen, MD, from the division of infectious disease at The University of North Carolina at Chapel Hill, UNC explained to MD Magazine at CROI 2017 in Seattle, Washington, that his team had worked for a very long time to try to understand different ways to prevent HIV.

The research they had completed was designed to understand the benefits of an HIV-positive patient in taking antiretroviral therapy (ART) for their own health, especially in terms of when they first start treatment. The team also sought to understand whether the person would remain contagious while the treatment was being administered.

According to Cohen, it’s kind of a very simple idea: if you take these pills, and they’re working to suppress the growth of the virus, shouldn’t you become less contagious?

But, the questions Cohen and team asked were regarding magnitude and durability.

The team conducted a study that lasted about 10 years with nearly 2,000 couples in relationships, and assessed if the infected person took pills, would he continue to be a risk to the uninfected person or would the risk diminish.

Cohen said they found in two separate publications (an interim report in 2011 and a final report last year) that the treatment is exceptionally good at stopping transmission. “We never saw an HIV-infected person transmit HIV when the treatment was successful. The only time we saw transmission from one person to another was when the treatment was unsuccessful — that was rare,” said Cohen.

Since 2011, ART persists to be the mainstay of the prevention strategy on the planet. Cohen pointed out that asking people to be tested for HIV is the beginning of all. Negative people could remain negative and positive people could get on treatment, which leads to a normal lifespan — basically taking one pill daily could render people not contagious.