Display Settings:

Format

Send to:

Choose Destination
See comment in PubMed Commons below
N Engl J Med. 2011 Aug 11;365(6):493-505. doi: 10.1056/NEJMoa1105243. Epub 2011 Jul 18.

Prevention of HIV-1 infection with early antiretroviral therapy.

Collaborators (579)

Veloso VG, Friedman RK, Cardoso SW, Calvet GA, Ribeiro MP, Tavares IC, Rocha MR, Fernandes NM, Moreira RI, Paiva M, Filgueiras S, Waite D, Morgado MG, Tuler L, Georg I, Neves I Jr, Andrade AC, Sena L, Torres T, de Oliveira MS, Hoagland B, Raxach JC, Pimenta C, Ribeiro V, Nunes J, Alves Lda S, Freitas RH, de Souza LH, Brum T, Bustorff F, do Nascimento MI, Portela LS, Ramalho A, Rodrigues AC, da Silva CL, de Chã TM, Joao EC, Sidi LC, de Melo MG, Lira RA, Zabtoski KR, Castro AC, Flores R, Grudzinski M, da Silva AL, Kliemann DA, Campello CM, Canti IC, Magalhães ES, Perez CF, Silveira ML, Barris J, Almeida ME, Seter MC, Turella ML, Fernandes CL, Curra L, Simon MR, Zabtoski SM, Miotto I, Chiarani F, Ramos DT, Gottert CC, de Melo MC, dos Santos RF, Gelman M, Maldonado A, Singal R, Safren S, Vanderwarker R, Srikrishnan AK, Sharma J, Thamburaj E, Arumugham J, Govindarajan N, Selvamuthu P, Paranjape R, Risbud A, Tripathy S, Gangakhedkar R, Sahay S, Kulkarni S, Ghate M, Thakar M, Dhayarkar S, Mane A, Kale V, Kulkarni S, Mahajan B, Brahme R, Joglekar N, Pradhan N, Krishnan S, Kanitkar S, Deshmukh R, Beri A, Katti U, Koli A, Alexander M, Kohli R, Deshpande S, Gaikwad A, Pawar J, Patil P, Kokil A, Nehete Y, Sheth P, Tupekar P, Patil P, Kulkarni P, Wagh Y, Mawal S, Dhamne P, Kharat M, Parkhe A, Momin A, Jadhav S, Baig M, Solas V, Birhade R, Karve L, Gade K, Panchal N, Ghodke U, Nalgirkar H, Gaikwad S, Patil L, Jivane S, Mamulwar M, Bangar D, Yadav R, Gorade M, Kad V, Palhade G, Bangale B, Shindekar S, Bankar V, Lakhwani K, Ganeshacharya S, Patil C, Jagdale A, Satyanna N, Patil A, Francis A, Chauware V, Kale S, Sharif N, Bingewar R, Gujar R, Malav V, Bhandarkar M, Chimanpure V, Chandane M, Hingankar N, Thorat S, Mankar S, Deshpande S, Nair S, Vaidya G, More D, Panchanadikar A, Pardeshi K, More C, Kumar K, Navlakha S, Kulkarni V, Wankhede S, Dadke D, Nene M, Kulkarni S, Suwanvanichkij V, Ruangyuttikarn C, Chotirosniramit N, Walshe L, Simmons N, Johnson L, Guptarak M, Chandler C, Lange HP, Prasarakee C, Sirisanthana T, Srithanaviboonchai K, Suwanvanichkij V, Kosashunhanan N, Thetket S, Sugandhavesa P, Supindham T, Chaiklang K, Nimsakul S, Chaikan W, Thongphan T, Sarachai S, Mueanapai S, Panyo N, Pookmanee S, Pruenglampoo B, Cheewawat W, Wongthanee A, Rungruengthanakit K, Keawvichit R, Wongworapat K, Sroysuwan P, Srichan R, Puisaeng B, Kosachunhanan N, Manoyos V, Sirikunpun S, Chuenchop N, Puisaeng B, Jaikuar N, Suriyasorgpi P, Dachapratoomwan K, Chanchai W, Chittpramodya D, Wongsrithep S, Chairungsri K, Puangpotha P, Petthed T, Jungsathit K, Chaikul K, Pasawad W, Yamano J, Leelasuksaree N, Kaewkosaba C, Suwannamas N, Naprom C, Yodkeeree P, Chandee L, Dokuta S, Pantip C, Sothanapaisan P, Keitkarn J, Jit-Aree W, Maneechai C, Boursuk K, Niwatananun W, Khad-Umong P, Sakkhachornphop S, Jongpaijitsakul P, Kabyoy N, Vannarit T, Bunthi C, Angkurawaranon C, Sakkhachornphop P, Kaewpoowat Q, Palanan P, Chaipin E, Sompong M, Wongphu-nga P, Saenrak N, Manop P, Chaiban R, Sirinam S, Khudcum A, Jannim A, Kunnapa R, Tammachai Y, Butphet S, Panyathep A, Putsyainunt P, Nunjai S, Ontakrai J, Khamdam P, Panyamang M, Chantan K, Auchieng C, Hanterdsith W, Prasertwitayakij W, Treamrangsee K, Dusara P, Bunga A, Makunike E, Salawu AO, Moyo S, Mangwendeza P, Mudenyanga C, Anderson M, Dzoro S, Mawoko N, Molebedi B, Oikantswe T, Moorad B, Malamba M, Mogaetsho E, Modise G, Mmolawa T, Retshabile G, Widenfelt E, Motsisi K, Tsomele T, Moseki E, Mongwa W, Kgafela M, Motsamai C, Masole S, Moiforay M, Madome K, Masopa S, Sifiwa N, Molapisi G, Akelo V, Chen B, Gust D, Lando R, Laserson K, Lebaron C, Nyagol B, Ondieki E, Zeh C, Ogendo A, Goldstine R, Vulule J, Mudhune V, Ayuo E, Gumbe A, Sewe V, Oyaro B, Chege W, Kretsinger K, Adhiambo J, Achola K, Anyiego E, Awuonda E, Kerubo E, Mimba E, Muhanji J, Ndivo R, Ngeno H, Nyamao G, Nyikuri M, Ochieng L, Odhiambo S, Odipo E, Odum E, Okola P, Okomo B, Ondenge K, Ouma GO, Ouma W, Rambara E, Were A, Adega A, Angira F, Atieno N, Ogutu E, Imbuki K, Katana A, Mboi P, McLellan-Lemal E, Okal D, Okanda J, Okello I, Omondi F, Omoro T, Ongwena P, Onyango K, Opollo V, Opuro R, Orimba G, Oruko J, Osoga J, Otieno F, Oyaa R, Akombi W, Kesa B, Obonyo N, Ochieng W, Odhiambo C, Odongo M, Oremo W, Ouma W, Owoko S, Matchere F, Carpenetti N, Kumwenda N, Nyirenda M, Zulu F, Seyama L, Kalonga B, Maliwichi M, Maseko B, Namalueso F, Kumwenda W, Mkandawire EM, Kamalizeni L, Shumba I, Martinson F, Krysiak R, Sichali D, Joaki G, Nkhalamba T, Mumba N, Kamwendo D, Tauzie J, Kilembe F, Saukila N, Kanyama C, Phiri G, Lugalia L, Mponda S, Moses A, Tegha G, Mkandawire N, Chinula L, Kandikole L, Singini G, Kumwenda T, Chimzimu F, Mindiera L, Kachipapa E, Mhango W, Tembo T, Dzama L, Mofolo I, Kharodia S, Gamah E, Sungitsa A, Mphande C, Potani C, Mshali I, Eliya H, Chinyama S, Katengeza E, Knhawazi L, Kanyika D, Kabudula C, Kamvaunamwali T, Chafuwa C, Chipeta M, Jumbe A, Mwanyimbo A, Mita K, Kulapani S, Mtanthira K, Mzinganjira D, Kumbanga F, Gondwe L, Lwanda F, Banda O, Dzowela T, Tembo T, Namarika D, Kachiponde F, Juma M, Chindebvu M, Kazembe R, Mathiya E, Yamba P, Chabwera C, Chauwa F, Mtika E, Mbeye N, Fiacco L, Kamanga S, Chilongozi D, Chanza H, Jumbe A, Chikhungu N, Ramdas Z, Munthali L, Limburo B, Mwausegha R, Mtombosola S, Gadi C, Majawa M, Phulusa J, Bandawe B, Gumbo A, Mwaipape A, Stambuli H, Msumba L, Mapanje C, Kasanbana K, Kayuni L, Badal-Faesen S, Conradie F, Graham V, Thebe JP, Ntshakala M, Manamathela M, Masimula J, Phakathi F, Komane K, Kubheka T, Knight M, Baines J, Rassool M, Ive P, Mwelase T, Mashabane N, Govender S, Dhlamini P, Radebe N, Lenkokile R, Nana A, Marx C, Conradie C, Tshabalala G, Montso M, Motlamelle M, Dyalom N, Mafela P, Essien T, Nshimiyimana T, Nhando N, Batani J, Njaya M, Hukuimwe M, Mandima PF, Murenje VT, Mutungamiri TD, Matanhike LT, Chirongoma L, Ruwende PN, Tichareva MN, Muhwati BS, Chirenda TH, Mhangami F, Magada ES, Nyamhuka M, Makwara J, Nyamayaro B, Mugari L, Manyara M, Chimuka E, Jokonya N, Musundire J, Matimba G, Mutsinze A, Kadziyanike G, Manomano S, Langa C, Maluwa C, Gurupira WT, Bafana T, Ncube E, Gomo A, Munjoma M, Makanza N, Mtisis F, Pamire C, Mashinga S, Kagona JB, Chahwanda M, Maguramhinga F, Chikosha M, Mandioma V, Talley J, Watkins P, Lucas J, White R, Cokley C, Sista N, Allen M, Hinson K, Cates W, Mastro T, Lamson N, Davis G, Yanavich C, Cottle L, Moksness J, Anderson M, Tracy-Waisanen S, Lands D, Kentop S, Robins-Morris L, Ou SS, Li X, Masse B, Donnell D, Hudelson S, Hendrix C, Gaydos C, Quinn TC, Redd A, Porcella S, Gupta A, Bollinger R.

Author information

  • 1University of North Carolina at Chapel Hill, Institute for Global Health and Infectious Diseases, Suite 2115, Bioinformatics Bldg., 130 Mason Farm Rd., CB 7030, Chapel Hill, NC 27599, USA. mscohen@med.unc.edu

Abstract

BACKGROUND:

Antiretroviral therapy that reduces viral replication could limit the transmission of human immunodeficiency virus type 1 (HIV-1) in serodiscordant couples.

METHODS:

In nine countries, we enrolled 1763 couples in which one partner was HIV-1-positive and the other was HIV-1-negative; 54% of the subjects were from Africa, and 50% of infected partners were men. HIV-1-infected subjects with CD4 counts between 350 and 550 cells per cubic millimeter were randomly assigned in a 1:1 ratio to receive antiretroviral therapy either immediately (early therapy) or after a decline in the CD4 count or the onset of HIV-1-related symptoms (delayed therapy). The primary prevention end point was linked HIV-1 transmission in HIV-1-negative partners. The primary clinical end point was the earliest occurrence of pulmonary tuberculosis, severe bacterial infection, a World Health Organization stage 4 event, or death.

RESULTS:

As of February 21, 2011, a total of 39 HIV-1 transmissions were observed (incidence rate, 1.2 per 100 person-years; 95% confidence interval [CI], 0.9 to 1.7); of these, 28 were virologically linked to the infected partner (incidence rate, 0.9 per 100 person-years, 95% CI, 0.6 to 1.3). Of the 28 linked transmissions, only 1 occurred in the early-therapy group (hazard ratio, 0.04; 95% CI, 0.01 to 0.27; P<0.001). Subjects receiving early therapy had fewer treatment end points (hazard ratio, 0.59; 95% CI, 0.40 to 0.88; P=0.01).

CONCLUSIONS:

The early initiation of antiretroviral therapy reduced rates of sexual transmission of HIV-1 and clinical events, indicating both personal and public health benefits from such therapy. (Funded by the National Institute of Allergy and Infectious Diseases and others; HPTN 052 ClinicalTrials.gov number, NCT00074581.).

Comment in

PMID:
21767103
[PubMed - indexed for MEDLINE]
PMCID:
PMC3200068
Free PMC Article

Images from this publication.See all images (2)Free text

Figure 1
Figure 2
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Icon for Atypon Icon for PubMed Central
    Loading ...
    Write to the Help Desk