Format

Send to

Choose Destination
N Engl J Med. 2016 Sep 1;375(9):830-9. doi: 10.1056/NEJMoa1600693. Epub 2016 Jul 18.

Antiretroviral Therapy for the Prevention of HIV-1 Transmission.

Collaborators (678)

Veloso VG, Friedman RK, Cardoso SW, Calvet GA, Diniz 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, Santini de Oliveira M, Hoagland B, Raxach JC, Pimenta C, Ribeiro V, Nunes J, da Silva Alves L, Freitas RH, Cardoso de Souza LH, Nazer da Costa SC, Santana de Moura S, Krstic T, Feitosa M, Lessa F, Siqueira Camacho LR, Brum T, Bustorff F, do Nascimento MI, Portela LS, Ramalho A, Rodrigues AC, Lopes da Silva C, Muniz de Chã T, 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, Portela LS, Ramalho A, Rodrigues AC, Lopes da Silva C, Muniz de Chã T, 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, Beulah F, Iqbal S, 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, Bingewar R, Gujar R, Mallav V, Bhandarkar M, Chimanpure V, 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, Mehendale S, Kurle S, Kadam A, Joglekar A, Bapat S, Angadi M, Athawale P, Lokhande N, Deshpande G, Inamdar D, Samuel M, Daware Y, Mundhe R, Chidrawar S, Jadhav S, Deoda R, Vaidya K, Kakru S, Kulal P, Raut P, Desai R, Ratnaparakhi N, Dudhmal L, Goli S, Mayekar M, Gaikwad A, Tayade N, Mashal I, Ghule U, Bodhe V, Shaikh A, Ghule S, Choudhari I, Chaturbhuj D, Lakhare P, Hingankar N, Chandane M, Thorat S, Shaikh N, Umakanth W, Vats M, Luwang A, Deshmukh B, Andil J, Khopkar P, Suwanvanichkij V, Ruangyuttikarn C, Chotirosniramit N, Walshe L, Simmons N, Johnson L, Guptarak M, Chandler C, Lange HP, Prasarakee C, Sirisanthana T, Srithanaviboonchai K, 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, 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, Ruanpeng D, Sitthi W, Siwilai P, 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, Mohammed T, Mupfumi L, Sekoto T, Pule O, Ralegoreng T, Sankoloba B, Maselwa V, 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, Nkhwazi 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, 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, Kachiwaya C, Mwagomba P, Banda T, Sankhani A, Varela A, Chigwenembe M, 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, van Amsterdam D, Mashamaite M, Mellet K, Alport B, Laher F, 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, de Bruyn G, Mkhize B, Motlafi R, Kistan J, 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, Jennings A, Robinson M, Moksness J, Anderson M, Tracy-Waisanen S, Lands D, Kentop S, Robins-Morris L, Ou SS, Li X, Masse B, Donnell D, Wang J, Ostbye K, Hendrix C, Gaydos C, Quinn T, Sievers M, Porcella S, Martens C, Bruno D, Swanstrom R, Ping LH, Dukhovlinova E, Hughes J, Gupta A, Bollinger R.

Abstract

BACKGROUND:

An interim analysis of data from the HIV Prevention Trials Network (HPTN) 052 trial showed that antiretroviral therapy (ART) prevented more than 96% of genetically linked infections caused by human immunodeficiency virus type 1 (HIV-1) in serodiscordant couples. ART was then offered to all patients with HIV-1 infection (index participants). The study included more than 5 years of follow-up to assess the durability of such therapy for the prevention of HIV-1 transmission.

METHODS:

We randomly assigned 1763 index participants to receive either early or delayed ART. In the early-ART group, 886 participants started therapy at enrollment (CD4+ count, 350 to 550 cells per cubic millimeter). In the delayed-ART group, 877 participants started therapy after two consecutive CD4+ counts fell below 250 cells per cubic millimeter or if an illness indicative of the acquired immunodeficiency syndrome (i.e., an AIDS-defining illness) developed. The primary study end point was the diagnosis of genetically linked HIV-1 infection in the previously HIV-1-negative partner in an intention-to-treat analysis.

RESULTS:

Index participants were followed for 10,031 person-years; partners were followed for 8509 person-years. Among partners, 78 HIV-1 infections were observed during the trial (annual incidence, 0.9%; 95% confidence interval [CI], 0.7 to 1.1). Viral-linkage status was determined for 72 (92%) of the partner infections. Of these infections, 46 were linked (3 in the early-ART group and 43 in the delayed-ART group; incidence, 0.5%; 95% CI, 0.4 to 0.7) and 26 were unlinked (14 in the early-ART group and 12 in the delayed-ART group; incidence, 0.3%; 95% CI, 0.2 to 0.4). Early ART was associated with a 93% lower risk of linked partner infection than was delayed ART (hazard ratio, 0.07; 95% CI, 0.02 to 0.22). No linked infections were observed when HIV-1 infection was stably suppressed by ART in the index participant.

CONCLUSIONS:

The early initiation of ART led to a sustained decrease in genetically linked HIV-1 infections in sexual partners. (Funded by the National Institute of Allergy and Infectious Diseases; HPTN 052 ClinicalTrials.gov number, NCT00074581 .).

PMID:
27424812
PMCID:
PMC5049503
[Available on 2017-03-01]
DOI:
10.1056/NEJMoa1600693
[Indexed for MEDLINE]
Free PMC Article

Publication types, MeSH terms, Substance, Secondary source ID, Grant support

Supplemental Content

Full text links

Icon for Atypon Icon for PubMed Central
Loading ...
Support Center