Researchers of a recently published study verified that early initiation of antiretroviral therapy (ART) reduces the progression of AIDS in individuals with mild opportunistic infections (OIs), infections that take advantage of weaknesses in immune defenses. Antiretroviral therapy involves the use of at least three antiretroviral drugs that slow down the progression of the HIV virus and prevent further damage to the immune system.

In the Phase 4 study, researchers separated subjects into two groups – one group received “early ART”, while another group received “deferred ART”. The early ART group started receiving antiretroviral therapy within 14 days of starting OI treatment, whereas the deferred ART group started receiving antiretroviral therapy after OI treatment was completed.

Researchers examined the primary outcome of the study at 48 weeks, which was divided into three categories:

1) Death/progression of AIDS
2) No progression of AIDS but incomplete viral suppression (i.e. viral load ≥50 copies/ml)
3) No progression of AIDS and viral suppression (i.e. viral load <50 copies/ml)

Researchers also examined several secondary outcomes, including AIDS progression/death. Secondary outcomes are objectives that are not the main focus of the study, but rather auxiliary to the primary outcomes.

The results of the primary outcome were not statistically significant; however, the results of the secondary outcome of AIDS progression/death did have significant results. In the early ART treatment group, AIDS had progressed in 20 subjects (14.2%) as opposed to the deferred treatment group in which AIDS had progressed in 34 subjects (24.1%). The early ART treatment group also had a longer time before AIDS progression/death.

The results show that ART should be started early in patients with AIDS-related opportunistic infections. Deferring treatment causes patients to become progressively more ill, and healthcare providers therefore lose opportunities to reduce the progression of AIDS. Starting ART early can prevent AIDS progression without adverse side effects, allowing patients to live longer lives.

For additional information please see the research article at the PLoS One Web site.