Four Reasons Why Early Treatment of HIV is Important

In the not-so-olden days, early treatment for HIV wasn't recommended. It was thought it was more useful to wait until people needed treatment. This was both because of the costs and the toxicity of HIV treatment. However, these days, people have recognized the long term benefits of early HIV treatment. Unfortunately, that doesn't always mean early HIV treatment happens.

Oe of the biggest barriers against people getting early treatment for HIV is a lack of testing. The CDC has recommended universal HIV testing for years. However, most of the mainstream medical community simply hasn't climbed on board. That's unfortunate, because early treatment is good not just for people with HIV. It's also good for the population as a whole. Why? There are a number of reasons...

1
Early Treatment May Keep You Healthier Longer

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Atmosphere during The 20th Annual Nautica Malibu Triathlon for the Elizabeth Glaser Pediatric AIDS Foundation at Zuma Beach in Malibu, California, United States. (Photo by Amy Graves/WireImage). Amy Graves/WireImage/Getty Images

There is a growing body of evidence suggesting that early HIV treatment reduces mortality. In other words, people who start HIV treatment sooner live longer. That means starting treatment when their CD4 counts are 350 or above. No more waiting to begin antiretroviral therapy until later.

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2
Early Treatment May Reduce Long Term Damage

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Reducing a person's exposure to HIV through early treatment, has unexpected benefits. It has been shown to reduce the risk of a number of long-term outcomes. This includes reducing the rates of a number of cancers, tuberculosis, and possibly even depression!

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3
Early Treatment May Keep The Viral Reservoir Small (or Non-Existant)

Studies suggest that early initiation of HIV treatment, within approximately the first 6 months after infection, may help keep the viral reservoir smaller. This is critical to the long-term health of individuals with HIV. It's the presence of a viral reservoir that makes HIV incurable.

Preventing the formation of such a reservoir, or at least decreasing its size through early treatment, is very important. Not only does it help slow the progression of HIV disease. It may make people living with HIV much easier to treat.

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4
Treatment as Prevention

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Individuals newly infected with HIV tend to have high viral loads. They also tend to be quite infectious to others. In fact, many researchers believe that HIV transmission most often takes place even before people know they are infected. Therefore, early detection and treatment is key. It's not only great way to improve the health of the infected person. It can also improve the health of their community,

By reducing a newly infected persons viral load, it is possible to also reduce the risk of transmission. Doing so is even cost effective. It's much less expensive to treat one person early than many people late.

However, it's important to mention that treatment as prevention isn't only relevant for those with new HIV infections. Working to maintain long-term undetectable viral loads through appropriate treatment is good for everyone. It helps infected people live longer, healthier lives, which is hugely important. Studies have also recently shown that it helps reduce the number of new infections in the communities in which they live.

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Conclusion

There are a number of potential benefits to early treatment of HIV. In fact, now that the side effect profile for antiretroviral drugs has improved, the main disadvantage is cost. However, cost effectiveness research may be starting to change that calculation. As doctors begin to realize that the price of treating one person early can work to improve the health and well being of not just that person but everyone around them, it may begin to seem like a bargain.

Sources:
 
Chan BT, Weiser SD, Boum Y, Haberer JE, Kembabazi A, Hunt PW, Martin JN, Mocello AR, Bangsberg DR, Tsai AC. Declining Prevalence of Probable Depression Among Patients Presenting for Antiretroviral Therapy in Rural Uganda: The Role of Early Treatment Initiation. AIDS Behav. 2014 May 1. [Epub ahead of print]
 
Goldman DP, Juday T, Seekins D, Linthicum MT, Romley JA. Early HIV treatment in the United States prevented nearly 13,500 infections per year during 1996-2009. Health Aff (Millwood). 2014 Mar;33(3):362-9. doi: 10.1377/hlthaff.2013.0830.
 
Grinsztejn B, [...] HPTN 052-ACTG Study Team. Effects of early versus delayed initiation of antiretroviral treatment on clinical outcomes of HIV-1 infection: results from the phase 3 HPTN 052 randomised controlled trial. Lancet Infect Dis. 2014 Apr;14(4):281-90. doi: 10.1016/S1473-3099(13)70692-3. Epub 2014 Mar 4.
 
Hong FF, Mellors JW. Changes in HIV reservoirs during long-term antiretroviral therapy. Curr Opin HIV AIDS. 2014 Nov 14. [Epub ahead of print]
 
Kowalkowski MA, Day RS, Du XL, Chan W, Chiao EY. Cumulative HIV viremia and non-AIDS-defining malignancies among a sample of HIV-infected male veterans. J Acquir Immune Defic Syndr. 2014 Oct 1;67(2):204-11. doi: 10.1097/QAI.0000000000000289.
 
Siegfried N, Uthman OA, Rutherford GW. Optimal time for initiation of antiretroviral therapy in asymptomatic, HIV-infected, treatment-naive adults. Cochrane Database Syst Rev. 2010 Mar 17;(3):CD008272. doi: 10.1002/14651858.CD008272.pub2
 
Smith MK, Rutstein SE, Powers KA, Fidler S, Miller WC, Eron JJ Jr, Cohen MS. The detection and management of early HIV infection: a clinical and public health emergency. J Acquir Immune Defic Syndr. 2013 Jul;63 Suppl 2:S187-99. doi: 10.1097/QAI.0b013e31829871e0.
 
Tanser F, Bärnighausen T, Grapsa E, Zaidi J, Newell ML. High coverage of ART associated with decline in risk of HIV acquisition in rural KwaZulu-Natal, South Africa. Science. 2013 Feb 22;339(6122):966-71.

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