Treatment for human immunodeficiency virus (HIV) four weeks after infection may make it possible to control the virus without medication in the long term, a new study has shown.
The finding reinforces the importance of detecting HIV early, according to researchers from the French Institut Pasteur, CEA, Inserm, University of Paris Cité, and the University of Paris-Saclay.
Treatment for HIV is called antiretroviral therapy (ART) and can be taken as a pill or an injection. The goal is to reduce a person’s viral load to an undetectable level so the person has no risk of transmitting HIV.
This therapy is now so effective that it can fully control the virus, with researchers even exploring ways to cure it.
This latest study looked at the impact of early treatment on primates with simian immunodeficiency virus (SIV), which is closely related to HIV.
The researchers found that very early treatment for two years led to controlling the virus even after treatment was interrupted.
“We show an association between early treatment and control of the infection after treatment is stopped, and our study indicates the existence of a window of opportunity to promote remission of HIV infection,” Asier Sáez-Cirión, head of the Institut Pasteur’s viral reservoirs and immune control unit and co-senior author of the study, said in a statement.
A previous 2013 study in humans had shown a similar possibility, suggesting that early treatment could allow people to stop treatment, with the virus in a “state of remission”.
The latest study also showed that the benefits of early treatment were lost if therapy was started just five months later. The findings were published in the scientific journal Nature Communications.
The researchers also looked at the effect of early treatment on the primates’ immune systems and capacity to fight the virus.
“We see that early treatment maintained for two years optimises the development of immune cells,” added Sáez-Cirión.
“They acquire an effective memory against the virus, to eliminate it naturally during viral rebound after stopping treatment”.
Starting treatment six months after infection, a delay that showed worse results in the study for long-term control of the virus, is “already considered very short compared to what happens clinically,” said Roger Le Grand, a co-author of the study from the French public research organisation CEA.
Most HIV patients, he said, start treatment years after being infected due to late testing.
The number of new HIV infections and AIDS-related mortality rates in Europe continue to decrease, according to the European Centre for Disease Prevention and Control (ECDC).
Yet many countries are not on track to achieve targets for ending the AIDS epidemic by 2030.
Around 83 per cent of people living with HIV know their status, according to the ECDC, which said that testing and treatment services in Europe need to be scaled up.