Starting treatment soon after HIV infection improves immune health, study finds
2014-11-24
(Press-News.org) In many countries outside the United States, decisions on when to start treatment for HIV infection are based on the level of certain white blood cells called CD4+ T cells, which are commonly measured to determine immune health. A study by National Institutes of Health grantees suggests that the best time to start treatment also should be based on how much time has elapsed since becoming HIV-infected. The researchers found that starting treatment within a year of seroconversion--the period within a few weeks of HIV infection when antibodies to the virus are first produced and their concentration reaches a detectable level--can improve immune health.
Sunil Ahuja, M.D., of the Veterans Affairs Center for Personalized Medicine and the University of Texas Health Science Center, and colleagues studied the influence of the duration of time elapsed between HIV infection and treatment initiation on the return of CD4+ T cells to a normal level. The investigators defined "normal" as 900 CD4+ T cells per cubic millimeter, based on previous studies. The level of these cells typically drops substantially in untreated HIV infection. By analyzing data from the ongoing U.S. Military HIV Natural History Study, in which more than 5,000 HIV-infected people are being observed over time, the scientists found that an HIV-infected person's CD4+ T-cell count is more likely to return to normal if treatment starts within a year of seroconversion and at a CD4+ T-cell count of 500 or more.
The researchers also found that achieving a normal CD4+ T-cell count and starting treatment within a year of seroconversion were associated with immune-health benefits. These included a reduction in the risk of developing AIDS, lowering of the inflammatory state of T-cells (which is associated with slower HIV disease progression), and more robust immune responses as manifested by a better antibody response to hepatitis B vaccine. According to the scientists, the study findings may support starting treatment soon after HIV infection while at a relatively high CD4+ T-cell count.
INFORMATION:
ARTICLE:
JF Okulicz et al. Influence of the timing of antiretroviral therapy on the potential for normalization of immune status in human immunodeficiency virus 1-infected individuals. JAMA Internal Medicine DOI: 10.1001/jamainternmed.2014.4010 (2014).
WHO:
Anthony S. Fauci, M.D., director of the National Institute of Allergy and Infectious Diseases, is available for comment.
CONTACT:
To schedule interviews, please contact Laura S. Leifman, (301) 402-1663, laura.sivitz@nih.gov.
NIAID conducts and supports research--at NIH, throughout the United States, and worldwide--to study the causes of infectious and immune-mediated diseases, and to develop better means of preventing, diagnosing and treating these illnesses. News releases, fact sheets and other NIAID-related materials are available on the NIAID Web site at http://www.niaid.nih.gov.
About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit http://www.nih.gov.
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[Press-News.org] Starting treatment soon after HIV infection improves immune health, study finds
