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Study finds early HIV testing is essential

Posted June 24, 2015

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— A large international HIV drug therapy study—Strategic Timing of Anti-Retroviral Treatment—found patients living with the disease should start therapy as early as possible.

Researchers at UNC Hospitals were among those who wanted to settle the question long debated among HIV physicians.

The START trial included more than 4,500 men and women infected with HIV. Some received early therapy, while others were deferred for later treatment.

“These findings will have a timely influence because the World Health Organization is updating its global HIV treatment guidelines right now,” WRAL health expert Dr. Allen Mask said. “The latest HIV drug therapies have fewer side effects than older therapies, helping patients live more normal lives as long as they stay on these regimens.”

Mask said many doctors worried about the lifelong side effects of starting the drugs too early. Others believed the earlier, the better.

Dr. David Wohl, a UNC AIDS clinical trials site leader—who was among those who pushed for early treatment—said the study tries to find the “sweet spot.”

“Even in the people who got treated, we see that there are events, heart attacks, infections, cancers, there were more in the people who waited to start therapy,” Wohl said. “So the sweet spot is early, it's not late. This study has put the cap on any sort of argument.”

According to Wohl, getting tested and knowing your HIV status is key.

“We now know, the minute you diagnose someone with HIV, they should start on HIV therapy,” Wohl said. “There's no waiting.”

The Centers for Disease Control and Prevention recommends that health care providers test everyone between the ages of 13 and 64 at least once as part of routine health care. One in seven people in the United States who have HIV do not know they are infected.

This study will be followed by more sub-studies, including one at UNC looking at the effects of earlier anti-retroviral therapy on the brain.

If you are at risk for getting HIV later on, you should get tested again. Dementia issues continue to be a problem for many young and middle age patients living with HIV.


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