In nine countries around the world,
1,763 couples have been participating in
the randomized clinical trial by taking oral
antiretroviral medicines earlier than current
guidelines recommend because their
immune systems are still healthy.
The study cost $73 million and was
funded largely by the NIH. The antiretroviral drugs used in the study were made
available by Abbott Laboratories,
Boehringer Ingelheim Pharmaceuticals,
Bristol-Myers Squibb, Gilead Sciences,
GlaxoSmithKline/ViiV Healthcare and
Merck & Co.
After a day of national media attention
and little sleep, Cohen and his team were
back in the lab: They were obsessed with
discovering why that one transmission
event had occurred.
“There’s so much work to do,” Cohen
said.
Cohen’s sense of urgency comes from
the staggering numbers of people affected
by AIDS and HIV.
In 2009, 2. 6 million people contracted
HIV worldwide, and 1. 8 million people
died of AIDS-related disease. Since HIV
was first recognized in 1981, 30 million
lives have been claimed.
Determining the number of lives that
could be saved by starting antiretroviral
drug treatments earlier than currently recommended requires further study and validation.
Cohen said he had been on the phone
with the United Nations the day after the
news conference announcing the findings.
“I imagine that they’ll change their recommendations for HIV treatment worldwide,”
he said.
Like most quality research studies, the
study known as HPTN 052 suggests solutions but raises questions as well.
“How do we best link people to care?”
said Vanessa Elharrar, a medical officer with
NIAID who worked on HPTN 052.
“How do we get people tested? How do
we retain people once they’ve started treat-
ment? What are the best interventions to
encourage adherence? There is much
research to be done.”
The study also raises ethical questions.
HIV patients often express concerns about
the side effects of antiretroviral drugs, wait-
ing as long as possible to start the treat-
ment.
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