Researchers analyzed data from nearly 500 patients infected with HIV-1 and found that those who began antiretroviral therapy within four months of their infection date -- and had higher CD4+ T-cell counts at the start of therapy -- had a stronger recovery of key CD4+ T-cell counts than those who began treatment later.
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Normal CD4+ T-cell counts were restored in 64 percent of patients who began antiretroviral therapy within four months of infection, compared with 34 percent of patients who began treatment later.
CD4+ T-cells -- specialized immune cells that fight infections -- are depleted in people with HIV, the researchers said. In the four months after a person is infected with HIV, the immune system tries to boost levels of CD4+ T-cells. After this temporary increase, levels of the cells begin to decline, explained the authors of the study, which was published Jan. 17 in the New England Journal of Medicine.
"This study suggests greater urgency to start antiretroviral therapy earlier, when the most weapons in the immunity armamentarium are at the body's disposal," co-lead author Dr. Sunil Ahuja, a professor of medicine, microbiology/immunology and biochemistry in the School of Medicine at the University of Texas Health Science Center at San Antonio, said in a center news release.
Ahuja also is director of the Veterans Administration Center for AIDS and HIV Infection, a national center within the South Texas Veterans Health Care System.
Other experts agreed that the study points to the importance of early treatment.
"The question of when to begin [antiretroviral therapy] remains a difficult one," but this study and others provide strong supportive evidence suggesting a benefit for early therapy, Dr. Bruce Walker and Dr. Martin Hirsch, of Harvard Medical School, wrote in an accompanying journal editorial.
-- Robert Preidt
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SOURCE: University of Texas Health Science Center at San Antonio, news release, Jan. 16, 2013
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