Prevention of HIV-1 Infection with Early Antiretroviral Therapy

• Published in: The New England journal of medicine Vol. 365; no. 6; pp. 493 - 505
• Main Authors: Cohen, Myron S, Chen, Ying Q, McCauley, Marybeth, Gamble, Theresa, Hosseinipour, Mina C, Kumarasamy, Nagalingeswaran, Hakim, James G, Kumwenda, Johnstone, Grinsztejn, Beatriz, Pilotto, Jose H.S, Godbole, Sheela V, Mehendale, Sanjay, Chariyalertsak, Suwat, Santos, Breno R, Mayer, Kenneth H, Hoffman, Irving F, Eshleman, Susan H, Piwowar-Manning, Estelle, Wang, Lei, Makhema, Joseph, Mills, Lisa A, de Bruyn, Guy, Sanne, Ian, Eron, Joseph, Gallant, Joel, Havlir, Diane, Swindells, Susan, Ribaudo, Heather, Elharrar, Vanessa, Burns, David, Taha, Taha E, Nielsen-Saines, Karin, Celentano, David, Essex, Max, Fleming, Thomas R
• Format: Journal Article
• Language: English
• Published: Waltham, MA Massachusetts Medical Society 11.08.2011
• Subjects: Adolescent; Adult; Allergies; Anti-Retroviral Agents - adverse effects; Anti-Retroviral Agents - therapeutic use; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antiretroviral drugs; Antiretroviral therapy; Antiviral agents; Biological and medical sciences; CD4 antigen; Counseling; Couples; Disease prevention; Disease Progression; Disease transmission; Disease Transmission, Infectious - prevention & control; Drug therapy; Drug Therapy, Combination; Enrollments; Fees & charges; Female; General aspects; Grants; HIV; HIV Infections - drug therapy; HIV Infections - prevention & control; HIV Infections - transmission; HIV Seropositivity; HIV-1; Human immunodeficiency virus; Human viral diseases; Humans; Infections; Infectious diseases; Kaplan-Meier Estimate; Laboratories; Male; Medical sciences; Pharmacology. Drug treatments; Population; Proportional Hazards Models; Public health; Sexual Partners; Sexual transmission; Spouses; Treatment Outcome; Tuberculosis; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Young Adult; Immunopathology; Antiretroviral agent; Chemoprophylaxis; HIV-1 virus; Retroviridae; AIDS; Immune deficiency; Lentivirus; Infection; Virus; Medicine; Chemotherapy; Treatment; Viral disease; Antiviral; Early; Human immunodeficiency virus
• ISSN: 0028-4793; 1533-4406; 1533-4406
• DOI: 10.1056/NEJMoa1105243

In this large, international study of HIV-1–serodiscordant couples, the receipt of antiretroviral therapy by the infected partner decreased transmission to the uninfected partner as well as rates of clinical events in the HIV-1–infected partner. Combination antiretroviral therapy decreases the replication of human immunodeficiency virus type 1 (HIV-1) and improves the survival of infected persons. 1 , 2 Such therapy has been shown to reduce the amount of HIV-1 in genital secretions. 3 – 5 Because the sexual transmission of HIV-1 from infected persons to their partners is strongly correlated with concentrations of HIV-1 in blood 6 and in the genital tract, 7 it has been hypothesized that antiretroviral therapy could reduce sexual transmission of the virus. Several observational studies have reported decreased acquisition of HIV-1 by sexual partners of patients receiving antiretroviral therapy. 8 – 11 These results have been extrapolated to . . .