Short Pulse Anti-Retroviral Therapy At sero-Conversion
Does taking anti-HIV treatment soon after infection delay damage to the immune system?
What was this study about?
Around 40 million people are living with HIV/AIDS around the world. Antiretroviral treatment (ART) is the main type of treatment for HIV/AIDS. It isn’t a cure, but it can help people stay healthy for many years.
The aim of this trial was to test whether a short period of treatment with ART in the early stages of HIV infection can delay the need for ART in the longer term. This was the first randomised controlled trial to test this approach to treatment.
The SPARTAC trial completed participant follow up in 2010. The SPARTAC results were analysed and results were published in 2013 in the New England Journal of Medicine. The SPARTAC trial results were presented at International AIDS Society (IAS) conference in Rome 2011.
What difference did this study make?
SPARTAC showed that giving people recently infected with HIV 48 weeks of treatment in the early stages of infection had some advantages, compared to no early treatment:
- It delayed the time to needing long-term treatment, though not much longer than the time already spent on 48 weeks of treatment (average of 65 weeks).
- Overall the group had healthier immune systems (an average of 138 more CD4 cells per mm3 blood) and lower amounts of virus in the blood (an average of 0.4 log10 copies of HIV RNA per millilitre blood more).
- These advantages were greater the closer the 48 weeks of treatment was started to the time of HIV infection.
There was no effect found in giving people recently infected with HIV 12 weeks of treatment, compared to no early treatment. There was no evidence of harm of early treatment in terms of deaths, adverse events and the effectiveness of long-term treatment later on.
More research is needed to understand why 48 weeks of treatment given to participants recently infected with HIV had certain advantages. Our findings suggest that it may be due to 48 weeks of treatment reducing the amount of hidden virus in the body (viral reservoir size).
Type of study
Who funded the study?
The Wellcome Trust (UK) (grant ref: 069598)
When did it take place?
Recruitment began in November 2004 and closed in July 2007. All patients were followed until December 2010.
Where did it take place?
Australia, Brazil, Italy, South Africa, Spain, Uganda, and the UK and Ireland.
Who was included?
Adults who tested positive for HIV within 6 months of having an HIV test which was negative. The target enrolment was 360 and 366 patients were enrolled.