Starting HIV treatment within two weeks of infection may keep individuals from developing antibodies to the virus while preserving their immune function, aidsmap reports. Researchers from the FRESH study recruited 300 South African women 18 to 23 years old who were at high risk of HIV and gave them HIV RNA tests at least twice a week and offered immediate treatment to the 42 women who contracted the virus. Findings were presented at the 21st International AIDS Conference in Durban, South Africa (AIDS 2016).
Twenty-eight of the women who contracted HIV started antiretroviral (ARV) treatment, 24 of them within 15 days of infection. HIV was detected within 15 days in 11 of the 14 women who declined immediate treatment.
In the untreated group, the women had a peak viral load in the eight figures 10 days after diagnosis. Three to four weeks after diagnosis, these women reached an average viral load set point of 30,000. Before contracting the virus, they averaged a CD4 count of 800, a figure that fell to 250 during their viral load peak and rose again to about 470 one month after diagnosis.
Those receiving immediate treatment saw their viral loads peak at 40,000 and then fall below 50 within a month of diagnosis. Their CD4 levels dropped somewhat as their viral load peaked and then returned to normal within 30 days of diagnosis.
Nineteen of the 22 women who were treated early and about whom there was complete data never developed HIV antibodies. The researchers found no connection between the women’s highest viral load and whether they developed antibodies, although they did find a relationship between missed clinic appointments and the development of antibodies.
There was a lack of CD8 cell responses to HIV in some of the women who took ARVs. And those treated women who did have CD8 cell responses to the virus had relatively few cells that were reactive to HIV, with those reactive cells showing a stronger response against the virus. By comparison, among the untreated women, the CD8 cells showing a response to HIV had a more muted response to that virus in particular, compared with CMV or influenza.
The study’s ethics committee currently believes that the women who were treated early should remain on HIV treatment for two to three years before they and the trial investigators discuss a possible treatment interruption. Only by interrupting treatment could the researchers observe whether the virus rebounds or shows signs that it might do so.
To read the aidsmap article, click here.