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For HIV treatment, the earlier the better

Editor’s note: This post originally appeared on Inquiry.

New Doctors treating people with HIV have faced a tough decision. Should patients begin drug therapy before AIDS symptoms appear, and put up with the inconvenience and potential side effects? Or is it better to wait until their CD4+ T cell count – a key barometer of the immune system’s health –drops below a certain level, even though that means a greater risk of transmitting the virus to a partner?

This summer an answer finally emerged. The international START (Strategic Timing of AntiRetroviral Treatment) study, the first large, randomized and controlled clinical trial of the issue, showed the benefits of early treatment so clearly that the trial was halted prematurely so the volunteers receiving deferred treatment could begin therapy.

“Early treatment was effective everywhere in the world,” says James Neaton, a University of Minnesota biostatistics professor and principal investigator for INSIGHT (International Network for Strategic Initiatives in Global HIV Trials), which designed and conducted the trial. “We had more than a thousand people enrolled from sub-Saharan Africa, and a total of 4,685 people from 35 countries.”

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In the News: U of M research confirms benefits of early HIV treatment

In a study conducted by the U of M, research found those with HIV should be put on antiretroviral drugs as soon as they learn they are infected, as announced by NIH officials.

The findings came in combination with a statement ending the study because the benefits of starting treatment right away were so definitive.

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University of Minnesota researchers find better time to start HIV therapy

Patients suffering from an AIDS-related infection should start therapy later than expected, according to a new study from the University of Minnesota Medical School.

In a report set to appear in the June 26, 2014, issue of the New England Journal of Medicine, researchers found that waiting 4-6 weeks to start HIV therapy after cryptococcal meningitis diagnosis resulted in 15% better survival than starting HIV therapy 1-2 weeks after diagnosis.

“The overall result is quite surprising. As with every other AIDS-related infection, starting HIV therapy sooner is better,” said the study’s lead author David Boulware, M.D., M.P.H. “It appears that brain infections are different.”

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Game Changer: Dominic Travis

In 2003, a team of scientists made a groundbreaking discovery tracing the origin of Human Immunodeficiency Virus (HIV) back to African monkeys. Since then, Dominic Travis, D.V.M.,has been at the forefront of a collaborative effort that seeks to fully understand how infectious diseases impact all primates — including humans.

“We try and find variables that connect habitat, wildlife, livestock and humans,” said Travis, wildlife veterinary medicine and epidemiology specialist at the U of M College of Veterinary Medicine.

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UMN, UNMC research shows persistent HIV replication is associated with lower drug concentrations in lymphatic tissues

Drugs used to treat HIV penetrate poorly into lymphatic tissues where most HIV replication takes place and there is persistent low-level virus replication in these tissues according to research from the University of Minnesota and University of Nebraska Medical Center.

“We know the drugs we use today are effective because our patients are doing better and living longer, but these drugs cannot cure the infection,” said Timothy Schacker, M.D., director of the Program in HIV Medicine at the University of Minnesota. “We wanted to know why and thought that maybe the drugs were not getting into the tissues where most virus replication is happening.”

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New anti-HIV drug target identified by University of Minnesota researchers

University of Minnesota researchers have discovered a first-of-its-kind series of compounds possessing anti-human immunodeficiency virus (HIV) activity. The compounds present a new target for potential HIV drug development and future treatment options.

Complete findings are printed in today’s issue of The Journal of Virology.

The compounds, known as ribonucleoside analogs 8-azaadenosine, formycin A, 3-deazauridine, 5-fluorocytidine and 2’-C-methylcytidine, were found to stop the replication and spread of HIV by blocking HIV DNA synthesis or by inducing lethal mutagenesis.

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