Results of studies presented at the IDWeek Conference in Washington suggest that initiating antiretroviral therapy (ART) early in the course of HIV infection leads to better long-term health outcomes than delaying ART.

The findings were based on the follow-up studies among 4,446 participants, which were conducted in the Strategic Timing of Antiretroviral Treatment (START) study.

In 2015, START found a 57% lower risk of developing AIDS and serious non-AIDS health outcomes among participants who began ART as soon as their CD4+ T-cell counts were more than 500 cells per cubic millimetre (mm3) than those who waited until either their CD4+ counts fell below 350 cells/mm3 or they contracted AIDS.

Participants who began ART before the end of 2015 had median CD4+ cell counts of 648 cells/mm3 in the early arm and 460 cells/mm3 for the deferred arm. During the second phase, those beginning ART in the deferred group showed rapid and sustained decreases in HIV viral load, but their CD4+ cell counts remained, on average, 155 cells lower than those of those beginning ART right away.

Although the risk of adverse health consequences was much lower in the deferred treatment group than in the early treatment group shortly after ART was initiated, some excess risk persisted.

The deferred ART group continued to have a higher chance (21%) of experiencing major health issues or death than the early treatment group. In the five-year follow-up period, there were 27 cases of AIDS in the disease-control group versus 15 in the early-treatment group.

The deferred treatment arm saw 88 significant non-AIDS health concerns, compared to 76 in the early treatment arm. The deferred treatment group saw 57 deaths, compared to 47 in the early treatment group.

These findings demonstrate the importance of early diagnosis and treatment in optimizing these advantages and reducing risk.

(Source: https://health.economictimes.indiatimes.com/news/diagnostics/early-hiv-diagnosis-crucial-for-better-long-term-health-outcomes/95022199)