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.”