The following is a summary of “A randomized prospective study to compare early versus delayed access to antiretroviral therapy over clinical and immunological sequel in HIV-positive adults,” published in the November 2022 issue of Primary care by Kumar, et al.

Treatment for acquired immune deficiency syndrome (AIDS) and human immunodeficiency virus (HIV) must start with antiretroviral therapy (ART) (AIDS). For a study, researchers compared the effects of immediate vs delayed access to ART on clinical and immunological outcomes in HIV-positive individuals.

The prospective, randomized, open-label trial included HIV-positive people who showed up at the ART facility, and it lasted for nine months. Patients who had a baseline cluster of differentiation (CD) 4 count of ≥350/mm³ at the beginning of their illness were enrolled in the early arm and the late arm if <350/mm³. Evaluation of disease progression in terms of functional status, opportunistic infections, and Centers for Disease Control and Prevention (CDC) stages were the main goals. An unpaired t-test, analysis of variance (ANOVA), Chi-square test, and Kaplan-Meier analysis were used in the statistical study, with a P value of <0.05 being considered significant at a 95% CI.

About 134 HIV-positive individuals who met the eligibility requirements were randomly assigned. Tenofovir + lamivudine + efavirenz (TLE) was given to all of the patients, including 60 in the early arm and 74 in the late arm. The CDC stages and immunological state were significantly different at baseline and after the start of ART (P-value< 0.001). The late arm had considerably (P-value = 0.006) more TB-HIV co-infections.

According to the study, the most crucial element in determining post-treatment recovery in terms of clinical and immunological outcomes was the CD4 levels at ART commencement.

Reference: journals.lww.com/jfmpc/Fulltext/2022/11000/A_randomized_prospective_study_to_compare_early.55.aspx