A 48-week course of antiretroviral medication taken in the early stages of HIV infection slows the damage to the immune system and delays the need for long term treatment, according to research published today in the New England Journal of Medicine. However, the delay was only marginally longer than the time already spent on treatment.
The study, the largest clinical trial ever undertaken to examine the effects of early HIV treatment, also suggests that the treatment lowers the amount of virus in the blood for up to 60 weeks after it is stopped, potentially reducing the risk of onward transmission.
SPARTAC (Short Pulse Anti-Retroviral Therapy at HIV Seroconversion), a randomised controlled trial, took place over five years and involved 366 adults – mainly heterosexual women and gay men – from Australia, Brazil, Ireland, Italy, South Africa, Spain, Uganda and the UK.
It was funded by the Wellcome Trust and coordinated by researchers from Imperial College London and the Medical Research Council's Clinical Trials Unit, with immunology research conducted by the University of Oxford.
This research into early treatment of HIV began in a laboratory headed by Professor Rodney Phillips at the University of Oxford in the late 1990s. Initial results, Professor Phillips explains, suggested that: 'very early treatment of HIV infection, shortly after the virus was acquired, could avert some of the damage done to the patient's immune system. These findings also suggested that if this protective effect was sustained then the inexorable downhill course of the infection could be attenuated.'
To transfer these techniques from laboratory to clinic, Professor Phillips teamed up with academics at Imperial College London with the aim of conducting clinical trials. Following further collaboration with the Medical Research Council and funding from the Wellcome Trust, this study became SPARTAC. Patient samples from across the four continents spanned by the study were processed at the Peter Medawar building, University of Oxford.
Professor Phillips says: 'Analysis of this material, coordinated by Dr John Frater, has yielded highly novel insights into the interaction between HIV, the human immune system and anti-HIV drugs.'