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Clinical round-up
  1. Mitesh Desai
  1. Correspondence to Mitesh Desai, Specialty Registrar in GUM, Department of Sexual Health & HIV, St Thomas' Hospital, London SE1 7EH, UK; mdesai.pub{at}gmail.com

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Early antiretroviral therapy (ART) that suppresses replication reduces HIV transmission by 96%

The findings of the first randomised control trial investigating the role of early ART on the prevention of HIV transmission were reported at the International AIDS Society Conference in Rome, Italy earlier this year with simultaneous publication in the New England Journal of Medicine.1

The HIV Prevention Trials Network 052 study, a multinational study, recruited 1763 serodiscordant couples. Fifty per cent of infected participants were male and 97% of couples were heterosexual. The HIV infected partner required a CD4 count between 350 and 500 cells/ml with no previous ART, except for the short-term prevention of mother-to-child transmission, and no active tuberculosis. They had to be willing to disclose HIV status to the uninfected partner, with whom they were in a stable relationship for at least the last 3 months, and reported three episodes of vaginal or anal intercourse during the same time period.

The couples were randomised on a 1:1 basis to receive immediate ART (early therapy group) or when CD4 count declined to ≤250 cells/ml or following an AIDS defining condition (delayed therapy group). Following enrolment, participants attended monthly for the first three visits and quarterly thereafter. An additional visit occurred at any time if a …

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