Early intervention with antiretroviral therapy (ART) in the weeks following HIV infection may significantly improve long-term viral control, potentially allowing individuals to manage the virus without continuous medication. The study, conducted by researchers from the French Institut Pasteur, CEA, Inserm, University of Paris Cité, and the University of Paris-Saclay, suggests a critical "window of opportunity" for achieving remission.
The research, published in Nature Communications, involved primates infected with simian immunodeficiency virus (SIV), closely related to HIV. The team found that initiating ART very early, and maintaining it for two years, led to sustained viral control even after the treatment was interrupted. This indicates that early treatment can establish a robust immune response capable of suppressing the virus long-term.
Impact of Early vs. Delayed Treatment
The study revealed a stark contrast between early and delayed treatment. Primates that started ART within weeks of infection experienced lasting benefits, while those who began treatment just five months later did not achieve the same level of viral control. According to Asier Sáez-Cirión, head of the Institut Pasteur’s viral reservoirs and immune control unit, early treatment optimizes the development of immune cells, enabling them to effectively eliminate the virus during viral rebound after stopping treatment.
Roger Le Grand, a co-author from the French public research organization CEA, noted that starting treatment six months post-infection is "already considered very short compared to what happens clinically," as many HIV patients begin treatment years after infection due to late testing. This highlights the urgent need for increased HIV testing and earlier diagnosis.
Implications for HIV Treatment Strategies
The findings build upon a 2013 human study that suggested early treatment could lead to viral remission, allowing individuals to discontinue medication. The latest research reinforces this possibility and provides insights into the immunological mechanisms underlying long-term viral control.
While new HIV infections and AIDS-related mortality rates are decreasing in Europe, many countries are not on track to meet the 2030 targets for ending the AIDS epidemic, according to the European Centre for Disease Prevention and Control (ECDC). With approximately 83% of people living with HIV aware of their status, scaling up testing and treatment services remains crucial to achieving epidemic control.
