Infectious Disease

Universal early treatment of HIV could reduce mortality

January 16, 2022

1 minute read

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Edwards does not make any relevant financial disclosures. The relevant financial information of all other authors can be found in the study.

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The researchers estimated that universal early initiation of HIV treatment would have slightly reduced the increased mortality rate in people living with HIV compared to the general population over the past 18 years.

“In previous work we have seen that mortality in people living with HIV was higher than mortality in the general population and that this difference in mortality persisted into the last calendar period we examined, 2011 to 2017. We also know that ART is effective in improving survival, particularly when administered early.” jessieand k. edward, promotion, a research assistant professor of epidemiology at the University of North Carolina at Chapel Hill, Healio said.

Microscopic_HIV

It is likely that mortality among people living with HIV would have decreased if they had been treated early. Source: Adobe Stock.

“In this study, we looked at the mortality of people living with HIV if they had been treated with ART within the first 3 months of starting HIV treatment to see whether expanding access to early treatment could offset this increased mortality for people with HIV would eliminate HIV,” Edwards said.

Edwards and colleagues calculated mortality over 5 years from entry into HIV treatment among observed treatment patterns for 82,766 adults who started HIV treatment at North American AIDS Cohort Collaboration clinical sites in the United States. They compared the result to the mortality rate for similar people in the general population, data from the National Center for Health Statistics.

Jessie Edwards

During the study period from 1999 to 2017, the 5-year mortality rate for adults living with HIV was 7.9 percentage points (95% CI, 7.6-8.2) higher than the expected mortality rate based on the US general population. The study showed that the increase in mortality rate for people living with HIV would have been 7.2% (95% CI, 5.8, 8.6) with universal early treatment.

In addition, the researchers found that in the most recent period studied, 2011-2017, mortality rates for people living with HIV among observed treatment patterns decreased by 2.6% (95% CI, 2, 3.3) and 2.1% (95% CI) increase , 0, 4.2) under universal early treatment.

“Rapid initiation of treatment after initiation of HIV treatment improves survival but is not sufficient to eliminate the increased mortality in people living with HIV,” Edwards said. “One reason may be that people often enter treatment late in the disease process – that is, with low CD4 cell counts – so treatment starts very late in the disease process, even if they are treated immediately after starting treatment.”

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