US study shows antiretroviral therapy for HIV-1 crucial in 1st 4 months after infection

Patients who start on antiretroviral therapy (ART) for HIV-1 infection within four months of estimated infection date demonstrate a stronger recovery of CD4+ T-cell counts than patients whose therapy starts later, a new U.S. study showed. The study, published on Thursday in The New England Journal of Medicine, is co-authored by physicians of University of Texas and University of California, San Diego. It drew data from 468 patients followed in the San Diego Primary Infection Cohort. In the four months after HIV-1 (human immunodeficiency virus type 1) infection, the immune system mounts an immune response toward a temporary restoration of CD4+ T-cell counts. After this transient increase, the CD4+ count progressively declines. CD4+ T- cells are specialized immune cells that are required to fight infections and are depleted during HIV infection. Recovery of CD4+ T-cell counts to approximately normal levels of 900 or more cells per cubic milliliter was observed in 64 percent of participants who were put on antiretroviral therapy within four months of the estimated date of infection, compared to 34 percent of participants for whom the ART was initiated later. "This study suggests greater urgency to start antiretroviral therapy earlier, when the most weapons in the immunity armamentarium are at the body's disposal," said co-lead author Sunil Ahuja, who is a professor of medicine at University of Texas.